SBS Professional Doctorates Collection - UQ staff and students only - UQ eSpace

How will we cope through this?! How testees and their support persons cope through genetic testing.

Ms Emma Ruddock — 2010-02-14T00:00:00Z

A substantive body of research indicates that presymptomatic and predictive genetic tests are important undertakings (Burke, 2002; Gaivoronskaia & Solem, 2004; Hicken & Tucker, 2002); these tests themselves, however, can be potentially stressful experiences both for those taking them (Dinc & Terzioglu, 2006; Hughes, Lerman, Schwartz, Peshkin, Wenzel, Narod, Corio, Tercyak, Hanna, Isaacs, & Main, 2002; Pakenham, Goodwin, & MacMillan, 2004) and those assisting them with support (Dinc & Terzioglu, 2006; Kenen, Arden-Jones, & Eeles, 2004). While preliminary research has identified variability in the ways in which people respond to the stress of genetic testing (Meiser, 2005; Patenaude, 2005b), reviews of psychosocial genetic testing literature highlight several gaps requiring attention (Broadstock, Michie, & Marteau, 2000; Duisterhuf, Niermeijer, Trijsburg, Tibben, & Roos, 2001; Grosfeld, Lips, Beemer, & ten Kroode, 2000; Salkovskis & Rimes, 1997; Schlich-Bakker, Ten Kroode, & Ausems, 2006). The purpose of this research was to address these gaps in current literature by: applying a stress and coping model to genetic testing; employing a longitudinal study design across three critical time points in the genetic testing process (pre-test, post-results and follow-up); including negative and positive adjustment measures; sampling those undertaking testing for a range of genetic diseases; and, incorporating the experiences of both testees and support persons. Two studies form the nexus of this thesis. Study 1 explored the experience of testees while Study 2 explored the experience of support persons. Sixty-five testees and support persons (42 testees and 23 support persons) participated in the research. Participants completed questionnaires at three crucial time points throughout the genetic testing process. In general, results provided support for the utility of the stress and coping model in explaining the adjustment of those undergoing a genetic test and that of their support persons. Results are discussed with consideration of the unique contributions of this research, and then in terms of limitations and implications for future research and clinical practice.

IF NOTHING CHANGES, NOTHING CHANGES: An ethnomethodological study that examines the processes of enduring change. The study reveals the displays of position of education change-agents about galvanizing a discourse of evidence-receptive English literacy pr

Mr Anthony John King Watt — 2009-05-14T00:00:00Z

English literacy teaching is contested terrain both internationally and in Australia. Most Western nations are currently working to improve standards of literacy because of empirical research into two foundational components of English literacy namely, reading and writing. Functional competence to read and to write in English results from competent teaching activity. This thesis investigates what changes to teaching displays of positions, knowledge, and action - or praxis - are required to overcome these aspects of illiteracy. To research this problem, the writer designed a theoretical model in the form of a cycle. The cycle demonstrates the enactment of beliefs and knowledge as displays of position. The most accessible form of that action is talk in conversation. Talk becomes the study. The words chosen for conversation become the data for analysis. The theory underpinning the cycle further proposes that words selected in talk carry discourses. The term chosen by the writer to describe this action, whereby talk brings dormant discourses to life, is galvanization. Of prime interest to the research were discourses of English literacy teaching. Seven selected senior educators, who act as curriculum change agents at the level of senior principal, academic or system leader, were each engaged in semi-structured interviews. Membership Categorization Analysis of the transcripts showed that the interviewees displayed positions that English literacy teachers were professionally oriented yet ambiguously led, child-centred and collaborative. Revealed in the data also was their displays of position that English literacy teachers are formed in a test-averse culture and left often to carry the blame for policy failure. A consistently accomplished category was deficient teacher. It relates significantly to a test-averse category. An additional accomplishment was the category evidence-receptive teacher. A second analytic pass of the data used Critical Discourse Analysis to reveal accomplished discourses of evidence. The analysis revealed that the galvanization of child-centred discourses repels discourses of evidence. This finding confirms the claim in the reviewed literature that English literacy praxis is contested terrain. Reconceptualized professional development strategies that generate changed praxis are proposed. The writer used the cycle to identify the most productive site to stage recommended auto-ethnographic studies by teachers in a coached and mentored environment. The cycle demonstrates just how preferred models of professional development should succeed. A well-resourced action research approach around a re-engineered discourse of classroom-generated evidence concludes the recommendations. Herein lies the remedy to allegations of failure of the moral obligations of English literacy teachers. Indicated is policy change that incorporates this research in new initiatives in teacher formation and continuous professional learning. The policy advocates the central positioning of a galvanized discourse of teacher designed evidence. The research has unfolded a carefully detailed model that will assist future professional development initiatives. The model draws attention to the crucial role of displays of positions for the process of galvanizing discourses. Because of this research, change agents might now avoid taking for granted crucial adult learning processes in the construction of new meaning driven or thwarted by displays of positions. The theorized cycle offers clear guidance to leaders during the planning and execution stages of continuous professional learning.

Information processing styles in autism spectrum disorder

Ms Valda Biezaitis — 2009-08-30T00:00:00Z

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder that affects approximately 0.6% of the population. A fascinating observation in ASD is the phenomenon of performance superiority. In the context of significant impairment in many areas of functioning, islets of ability are often displayed by people with ASD. Numerous theories have been circulated in an attempt to explain the findings of performance superiority, as well as other characteristics of ASD. Probably the most prominent such theory discussed in the ASD literature is the weak central coherence theory. The current project was dedicated to exploring the assessment of weak central coherence cognitive style, thought to characterise ASD. The ultimate goal here was to further general understanding of ASD and weak central coherence, with applicability to clinical practice. Chapter 1 of this dissertation provides an exploration of both historical and contemporary research literature describing the features and peculiarities of ASD. This review places particular emphasis on the weak central coherence theory of ASD, and leads into the core issues that were explored in the current project. Chapter 2 follows on with a review of the broader cognitive style literature. Drawing connections between the broader cognitive style literature and weak central coherence theory, a focus of this chapter is then on measurement. In response to problems with the measurement of cognitive style identified in the literature, two new alternative approaches to the assessment of weak central coherence style at the individual level are proposed. Chapter 3 outlines the first empirical study of the current project, which provided an important opportunity to trial the new assessment approaches in the general population. Addressing the issues arising from the preliminary study outlined in chapter 3, and in preparation for the primary clinical study of the current project, chapter 4 explores three issues: the addition of a new complementary task to the battery for assessment of weak central coherence cognitive style; the utility of single-case study methodology in ASD and weak central coherence research; and the rationale and decisions made regarding diagnostic and inclusion criteria for participants in the primary clinical study. Chapters 5 and 6 outline the primary clinical study of the current project. This study was conducted with a group of high functioning, school-aged children diagnosed with ASD, and a comparison group matched on age, gender and nonverbal IQ. The study aimed to explore the variation of weak central coherence style in ASD, and to further develop an approach to the assessment of weak central coherence style. Chapter 5 outlines analyses of performances on weak central coherence tasks conducted at the group level, as well as examining patterns between tasks used in the assessment of weak central coherence. Individual differences in style approach are explored utilising single-case study methodology in chapter 6. In chapter 7, the findings of the current project are summarised around several key research contributions. Firstly, the need for further refinement of the weak central coherence model is emphasised, and suggestions for future directions in model development are made. Secondly, considerations for the future improvement of weak central coherence assessment methods are suggested. Also, after highlighting variation of weak central coherence style within ASD in the current project, the need to further explore both possible subgroups on the central coherence dimension and the typical variation of style approach within the general population is emphasised. Finally, the value and importance of utilising single-case methodology in the assessment of weak central coherence style and research with the ASD population is highlighted. The implications of the current research for both researchers and clinicians are considered in chapter 7, and suggestions for how to facilitate the transition of the weak central coherence theory from the research laboratory to applied therapy and educational settings are also made.

Investigation of Social Support in Newlywed Couples as a Predictor of Relationship Satisfaction: A Longitudinal Study

Ms Monica Koblik — 2010-11-24T00:00:00Z

Numerous studies have found a correlation between spousal social support and relationship satisfaction in married couples, and it has been suggested that partner social support helps couples sustain relationship satisfaction. However almost all of this research utilised cross-sectional methodology, and often relied on self-reported support that has been shown to be unreliable. One notable exception was the study of Pasch and Bradbury (1999) who found observed social support behaviours predicted three classes of future relationship satisfaction: highly satisfied, satisfied and distressed. However, there are several limitations to the Pasch and Bradbury study including the use of large numbers of predictors that inflated the Type 1 error, classifying a continuous outcome of relationship satisfaction into classes, and confounding relationship satisfaction with relationship dissolution in the distressed class. The current study was a replication and extension of the work of Pasch and Bradbury addressing these methodological shortcomings. Two-hundred and forty-one newlywed couples participated in a social support task at time 1 approximately eight weeks after they were married. Each partner discussed a personal but not relationship related issue for 5-minutes while the partner responded as they normally would. Interactions were audiotaped and coded for positive and negative social support behaviours. Couples completed a measure of relationship satisfaction five times at annual intervals. Multilevel modeling (MLM) was used to predict the trajectory (initial satisfaction and slope of linear change across time) of relationship satisfaction from the social support behaviours at time 1. Negative couple behaviours, and positive behaviours when supporting the woman, predicted the initial relationship satisfaction of both women and men. However, contrary to predictions, social support behaviours did not predict the slope of linear change of relationship satisfaction across time. These results do not support the assumption that social support has a causal impact on relationship satisfaction.

Is sexual abuse in earlier life a risk for older women's mental health? An investigation, including of risk and protective factors.

Melissa Sands — 2011-10-19T00:00:00Z

Abstract Background: Incidents, correlates and outcomes of lifetime sexual assault and unwanted sexual contact have rarely been investigated in older women. This is despite the fact that it is well known that very high rates of females experience such incidents throughout childhood and well into mid adulthood, along with a range of serious aversive consequences. Older women’s sexuality, generally, has received a limited degree of attention in the literature, and much remains unknown about the sexual experiences of women in older age. Both normal sexuality and forms of unwanted sexual contact in older women are likely to have been ignored in the literature previously, due to the general societal view that equates aging women with asexuality. This study reviewed the literature in these areas and undertook to explore the risk of aversive outcomes for older women who reported a lifetime history of sexual abuse, as well as any protective factors, particularly those relating to disposition (e.g., optimism, self-efficacy, self-esteem, internal locus of control) and social support. Method: Community-dwelling participants (N = 474; age range 44 to 83 in 2004), were drawn from the Longitudinal Assessment of Women (LAW) study, and in 2004, participated in an interview about their sexual abuse history. Further data was collected through a combination of mailed questionnaires (in 2004, 2007 and 2008), and a personal clinical interview conducted by a physician in 2008. Results: A history of sexual abuse was reported by 27.49% of women, with most incidents occurring in childhood. Women’s reports of lifetime sexual abuse declined with age. In 2008, 10.85% of the total remaining sample had a clinical psychiatric diagnosis. Hierarchical logistic regression analyses demonstrated that psychopathology was predicted from a history of sexual abuse (with an Odds Ratio of 2.39), after taking into account the predictive effects of neuroticism (with an Odds Ratio of 2.32) and other factors (e.g. demographic). Participants reporting sexual abuse were more likely to have lower perceived social support and to be higher on the personality factor openness, though they did not differ on dispositional features. Dispositional factors also did not predict a reduced risk of psychopathology. In 2008 when the clinical interview was conducted, missing participants (comprising 20.3% of the original sample) were noted to have had lower scores on income, education, agreeableness, self-efficacy and internal locus of control. Conclusions: Sexual abuse, even occurring much earlier in life, appears to place older women at greater risk of psychopathology and is associated with reduced perceived social support. Dispositional factors may not always be affected by sexual abuse, or otherwise, may recover with time. Older women may be at particular risk from effects of sexual abuse, due to competing social messages received about sexuality. Women may desire the ability to express sexuality in a changed and more affectionate way as they age, which may conflict with social and medical messages transmitted to older men, raising issues of consent and common goals with respect to intimacy.

Learning Patterns of Adolescents with Psychotic Disorder: Case Studies of Reading Behaviour

Mrs Tracey Lye — 2009-05-26T00:00:00Z

The onset of Psychotic Disorder in adolescence has serious long-term debilitating effects on those who develop the disorder. Current research focus in Psychotic Disorder is to develop treatment strategies for early intervention aimed at intervening prior to irreversible cognitive decline, or to mediate the effects of cognitive decline. Little is currently known about the trajectory of cognitive deficit prior to the first episode of psychosis. Through a series of case studies, this study investigates the progress of cognitive development in early course of psychosis, through the functional learning of adolescents with Psychotic Disorder. The participants were four adolescents aged 14 to 18 years, clinically diagnosed with a psychotic disorder, with onset in adolescence. All participants had disturbances of executive function, memory and attention that could be traced back to early school years. All experienced a noticeable cognitive decline within 12 months prior to their first psychotic symptoms. Significant deficits in reading comprehension relative to peers, was identified in all participants. Measures of reading rate and reading accuracy indicate that decline in reading comprehension occurred after the acquisition of reading as a skill and prior to the onset of psychotic symptoms. The study examines the functional skill of reading as a measure of change in cognitive development.

Listen Up: Self-Selected Music as a Tool for Emotion Regulation in Young People

Miss Hollie Shannon — 2012-10-01T00:00:00Z

This thesis reports on two studies of music listening to regulate emotional states in young people. Study 1 examined the utility of self-selected music listening to regulate anxiety related to assignment writing. Sixty university students (Mage = 18.61 years) in the non-clinical range on mood symptoms were randomly assigned to one of three experimental conditions: music before, music during, or no music. Participants in the music conditions listened to self-selected music either before or while writing an assignment plan, while the no music condition completed the task in silence. Using physiological (i.e., skin conductance) and self-report measures, the specific aim of this study was to examine the effect of self-selected music listening on university students’ arousal, valence, and urge to procrastinate. Despite a discrepancy between subjective and physiological arousal levels in response to music listening, results of mixed analyses of variance showed that participants’ arousal ratings started decreasing when they listened to music (in comparison with the no music condition). Additionally, there was a trend in the data which suggested that participants’ valence ratings started improving when they listened to music, however, this between conditions effect failed to reach significance. Music listening was found to have no effect on participants’ urge to procrastinate. Finally, there was a significant interaction between condition and time such that participants in the music before condition reported significantly reduced arousal in the anticipatory phase of the assignment task (i.e., when they listened to their self-selected music), whereas participants in the music during and no music conditions continued to report elevated arousal at this time. This supports the conceptualization of assignment anxiety as an anticipatory phenomenon. Study 2 was intended to further examine the link between music listening and emotion regulation in a homework emotion regulation task. This study adopted a randomized between-group comparison where one group used music listening and the other group used thought challenging to regulate emotional states. Fifty-nine university students (Mage = 18.91 years) in the non-clinical range on mood symptoms were randomly assigned to complete weekly self-monitoring in the form of either a music diary or thought record for a one-month period. Participants were assessed at pre- and post-treatment on the Difficulties in Emotion Regulation Scale (DERS), Depression Anxiety Stress Scale (DASS-21) and Music Affective Response Scale (MARS), as well as weekly ratings on five key emotion variables (e.g., ability to name emotional states; confidence in managing strong emotions). Further, the effectiveness of the music diary and thought record in regulating the emotional states of participants was assessed via self-reported ratings of valence and arousal. Results showed that despite a lack of change in mood symptoms and emotional sensitivity to music over the four weeks, the music diary and thought record produced comparable improvements in the emotion regulation skills of participants and were equally effective in regulating emotional states. Repeated measures analyses showed that both groups significantly improved on all five weekly ratings of emotion, with no differences observed between the two groups. Furthermore, participants rated the music diary as a more effective and engaging emotion regulation strategy than the thought record. In conclusion, this research shows that strategic music listening can be used to regulate emotional states in young people not only in a laboratory but in everyday life.

Marriage and cohabiting relationships: Is there a difference?

Mrs Nicole Arthur — 2009-02-05T00:00:00Z

Abstract Social ties are integral to health and well-being, with marital relationship status being one of the most important predictors of health and well-being. Although contemporary research usually treats cohabiting relationships as equivalent to marriage, research suggests that significant differences in health and well-being may exist between married and cohabiting individuals. Because the majority of this research is cross-sectional, however, it is not clear whether pre-existing differences lead individuals to select marriage or cohabitation, or whether the differences arise from the nature of the relationships. Additionally, evidence suggests that differences exist between men and women in the health and well-being correlates of various relationship states. These findings are important at both methodological and clinical levels. If these two groups are meaningfully distinct then it is important that they are treated separately in research. Secondly, if cohabiting relationships are different from marriages, or if different individuals move into them, this has relevance for both couple and individual therapy and potentially in the prevention of relationship breakdown. The Australian Longitudinal Study on Women’s Health (ALSWH) provides an opportunity to examine marriage and cohabitation longitudinally within a national sample of women. Women who were single at Survey 2 (N = 3868, aged 22-27) were divided into three groups – those who would still be single at Survey 3, three years later, those who would be married, and those who would be in cohabiting relationships. Firstly, the study explores pre-existing differences at Survey 2, when all women were single, in sociodemographic, physical health, health behaviours and psychological variables. Secondly, it explores whether differences exist on these same variables at Survey 3, after the transition, and thirdly it explores whether post-transition differences can be explained by pre-existing differences between the groups of women. Using a selection of variables assessing sociodemographic status, health behaviours, physical health, and mental health, results suggest that there are both pre-existing differences between these three groups of women and differences that are apparent after the transition. Statistical adjustment for pre-existing differences attenuates, but does not completely remove, the post-transition differences. These findings suggest that both selection and social integration processes may be influential in determining women’s relationship status and health and well-being. These results have implications at both a methodological and clinical level. The findings would suggest that women who go on to cohabit are a meaningfully distinct group of individuals from those who marry, and thus need to be treated as a separate population in future research. Secondly, in terms of clinical practice, increased recognition of and understanding that pre-existing differences between women with different relationship status as well as differences in social interaction processes within the relationship environments may impact on the efficacy of individual and couple relationship therapy should be an important consideration in the delivery and structuring of an efficacious treatment program.

Meaning making processes in chronic illness: The nature of sense making and benefit finding in people living with chronic fatigue syndrome

Mr Timothy Lowry — 2010-11-16T00:00:00Z

Chronic illness can be a devastating and life altering experience that propels a search for meaning in life. Chronic fatigue syndrome (CFS) is one of the most incapacitating chronic health conditions, with evidence showing significant detrimental impacts on all aspects of daily living including relationships, self care, occupational functioning, and recreational pursuits. This research aims to explore the search for meaning or ‘meaning making’ in those with CFS. Theoretical perspectives hypothesise that experiences of adversity, such as chronic illness, can disrupt or shatter fundamental assumptions and positively skewed worldviews, thereby exposing an individual to their mortality and the fragility of life. Such exposure is said to confront the individual with a meaninglessness world, thereby propelling a search for meaning and triggering meaning reconstruction or ‘meaning making’ processes that may lead them to develop explanations for (sense making) and find benefits in (benefit finding) their adversity. These two construals of meaning have been found to impact on both positive and negative indicators of adjustment to adversity. While explored across other illness groups, research to date has not examined meaning making (sense making and benefit finding) in people living with CFS. The current research therefore seeks to address this gap in both the CFS literature specifically, and the broader chronic illness literature. Study one investigated the nature of sense making in people living with CFS, and relations of sense making with both demographic and illness-related variables, and adjustment. A mixed-methods approach was utilised incorporating both qualitative and quantitative analysis, with sense making conceptualised as both a dichotomous (sense made / sense not made) variable, and continuous variable (number of sense making explanations). Anticipated sense making in those who reported not having made sense of their CFS was also explored, however was found unrelated to all adjustment outcomes. Results showed that just over half the sample (54%) reported that they were able to make sense of their having CFS, with almost all of these participants (93%) able to generate sense making explanations for their illness. Content analysis of qualitative data revealed twelve prominent sense making themes including ‘Change to lifestyle’ (41%), ‘Causal explanation’ (39%), ‘Experienced growth’ (29%), and ‘Acceptance’ (21%). While many of these themes were similar to those reported by other illness groups, those with CFS were also found to generate other CFS-illness specific sense making explanations (e.g., ‘Resolution of past concerns’). Bivariate analyses revealed that the continuous sense making variable was related to gender, specifically, females reported a higher number of sense making categories than males. Sense making was found unrelated to all illness-related variables. Multivariate analyses revealed that sense making evidenced beneficial direct effects on adjustment outcomes after controlling for gender; specifically, making sense of CFS was related to higher levels of positive affect and life satisfaction, and lower levels of depression, while a higher number of sense making categories was related to greater life satisfaction and lower levels of anxiety. Study two investigated the nature of benefit finding in people living with CFS and relations with both demographic and illness-related variables, and adjustment. A mixed-methods approach was again utilised incorporating an established measure of benefit finding (Benefit Finding Scale [BFS]; Mohr et al., 1999), plus qualitative methods to explore additional benefits emerging from the CFS illness experience that were not included in the BFS. Findings demonstrated that despite the significant negative impacts of CFS, many people with the condition reported a wide range of benefits. Factor analysis of the benefit finding measure indicated three factors (‘Personal growth’, ‘Family relations growth’, and ‘Growth in independence’). Dimensions of benefit finding were found to be associated with age, and the illness-related variables illness duration, physical disability, and fatigue severity. Multivariate analyses revealed that dimensions of benefit finding displayed differential relations with adjustment domains. While the ‘Family relations growth’ factor was found to be unrelated to all adjustment outcomes, the ‘Personal growth’ factor was found to be associated with indicators of positive adjustment (positive affect, dyadic adjustment, and life satisfaction). Additionally, the ‘Growth in independence’ factor was positively associated with positive affect. Further, benefit finding was found unrelated to the negative adjustment domains of depression and anxiety supporting theory regarding the concurrent existence of both positively and negatively toned emotions. Qualitative analysis revealed that 41% of respondents reported additional benefits, with 10 benefit finding themes emerging including themes not included in the BFS (for example, ‘Health awareness and lifestyle change’, and ‘New possibilities / opportunities’) . This research provides the only examination of sense making and benefit finding in those with CFS, and adds to the limited number of studies examining meaning-making in chronic illness. Results indicate that those with CFS engage in meaning-making processes, specifically constructing explanations for the occurrence of the illness in their lives and identifying benefits emerging through their illness experience. Further, sense making and benefit finding appear to be multi-dimensional in nature, evidencing differential relations with both demographic and illness variables, and domains of positive and negative adjustment. Findings highlight the need for further longitudinal research in this area and the development of reliable and valid CFS specific multi-item and multi-dimensional measures for the comprehensive assessment of sense making and benefit finding. Findings from this research also hold potential clinical practice implications that could inform the development of meaning-based interventions not only for those with CFS, but also more broadly for those with chronic illness; specifically incorporating both distress-relieving and meaning-enhancing strategies.

Measuring Alcohol Craving: Development of the Alcohol Craving Experience

Ms Dixie Statham — 2010-01-27T00:00:00Z

Abstract The role of craving in alcohol dependence is well-documented and several measures have been developed to explore and quantify this phenomenon. The literature shows that these measures suffer from considerable theoretical and methodological limitations. The aims of this project were to develop a robust measure of craving based on the Elaborated Intrusion Theory of Desire (EI) [Study 1] and to examine the construct, concurrent, discriminant and predictive validity of the instrument [Study 2]. In Study 1, a 29 item questionnaire, The Alcohol Craving Experience questionnaire (ACE) was developed based on the key features of craving as described by EI: the sensory aspects of craving (imagining taste, smell and somatic sensations of drinking), and the intrusiveness of thoughts and urges about drinking. The ACE consisted of two parts. In the first part, participants used an 11-point, visual analogue scale to report on the intensity of their craving experiences at a time of maximal intensity (focal period) in the previous week. In the second part, participants indicated the frequency of their craving experiences during the same week. One hundred and fifty individuals receiving treatment for Alcohol Use Disorders completed the ACE. Exploratory factor analysis demonstrated a clear three-factor structure representing Imagery, Strength and Intrusion for both the focal period and for frequency. In Study 2, an independent sample of 299 individuals receiving treatment for Alcohol Use Disorders completed the ACE. Using confirmatory factor analysis two items from the first part of the questionnaire and five items from the second part were removed. The final revised version of the questionnaire consisted of 22 items, and the three-factor structure provided a good fit for both parts of the questionnaire. Concurrent validity with the ‘gold standard’ measure of craving, the Obsessive Compulsive Drinking Scale (OCDS), and with measures of alcohol consumption, alcohol dependence severity, depression, anxiety and stress (DASS), and alcohol expectancies (DEP) was demonstrated. The ACE was able to discriminate between individuals in the clinical sample and those in an independent non-treatment seeking sample (N = 204) of university students. In the student sample, the ACE also discriminated between those who screened positive for alcohol dependence on the Alcohol Use Disorders Identification Test and those who did not. Post-treatment data were obtained for a sub-sample of the clinical group. The ACE was associated with increased days abstinence at three month follow-up. Overall, the ACE performed well as a robust measure of craving. Further research could explore the application of this instrument with other alcohol using populations, for example, non-treatment seeking drinkers and heavy episodic alcohol consumers. Modifications of the ACE could be tested with other addictive substances.

Neuropsychological and Psychosocial Functioning in Patients with Alcohol-Related Liver Disease Pre- and Post-Liver Transplantation

Ms Nell Pegum — 2008-10-29T00:00:00Z

Observed Psychologist Empathy, Therapeutic Process and Outcomes for Couples from Relationship Education.

Bate, Karina S — 2012-10-29T00:00:00Z

The Therapeutic Alliance predicts individual and couple therapy outcome, but the potential impact of alliance on prevention program outcomes is largely untested. The aim of this thesis was to test whether therapist empathy enhances outcome for couples after relationship education, and whether any effects of therapist empathy were moderated by the level of risk for future relationship distress of couples. Using a longitudinal design, the current study assessed observed empathy during sessions of Couple Relationship Education (CRE) provided to 53 heterosexual couples, who were participating in a randomized controlled trial of the Couple CARE program. The CRE was provided to couples in their own home via a DVD, structured couple exercises and relationship educator contact via the internet. Spouses’ engagement with key program activities and the extent of their relationship enhancing behaviours during participation were assessed, as well as couple relationship satisfaction before and after CRE. Using evidence-based indices of relationship distress, each couple’s risk for future relationship problems was also assessed. Couple relationship satisfaction improved following participation in CRE. Pre-CRE relationship satisfaction was not reliably associated with educator empathy. Relative to couples who had lower risk for future relationship problems, high risk couples were less satisfied prior to participation, and more likely to drop out during CRE. However, risk did not predict changes in satisfaction after CRE. Empathy predicted higher engagement with program tasks for low-risk but not high-risk couples. Contrary to predications, empathy did not predict the number of CRE sessions completed, the extent of relationship enhancing behaviours attempted, or the improvement in relationship satisfaction. The results suggest that even a modest level of empathy is sufficient for CRE to have a positive effect. Empathic educators seem to enhance engagement for lower risk couples, whereas higher risk couples who continue with CRE show high engagement independent of therapist empathy, possibly because they are motivated to engage in CRE to enhance their relationship. Implications for psychological practice, training and future research are discussed.

Paediatric post-concussion symptoms: Predictors and preliminary evaluation of parent and child psychoeducation resources for the prevention of paediatric post-concussion symptoms

Miss Katherine Olsson — 2011-02-18T00:00:00Z

A significant proportion of individuals will experience post-concussion symptoms (PCS) following a mild traumatic brain injury (mTBI) (Kashluba, Paniak, & Casey, 2008; Yeates et al., 1999). In children, persistent PCS are thought to be due to injury characteristics (e.g., severity), post-injury cognitive difficulties, acute PCS, and pre- and post-injury child and parent psychological distress (Yeates & Taylor, 2005). Recently both female gender and younger age at injury have also been associated with increased PCS following mTBI (Carroll et al., 2004; Taylor et al., 2010). Unfortunately persistent PCS are linked with adverse psychosocial outcomes, including increased psychological distress, poorer health related quality of life (HRQOL), and academic functioning (McCauley, Boake, Levin, Contant, & Song, 2001; McCauley et al., 2005, 2007; Yeates & Taylor, 2005). As such, the primary aims of this thesis were (a) to review the theoretical and empirical predictors of PCS and establish the usefulness of these predictors in a paediatric population with mTBI, and (b) to develop and pilot test a child psychoeducation website and parent information booklet for the prevention of persistent paediatric PCS. This thesis is divided into four chapters. Chapter 1 describes key concepts, outcomes of mTBI, and highlights methodological limitations of the literature (e.g., absence of a well accepted definition of mTBI), that will be addressed by this thesis. Chapter 2 aimed to comprehensively review and evaluate theoretical and empirical predictors of PCS at six and 18 months post-mTBI. Children aged 6 – 16 years with uncomplicated (n = 132) and complicated mTBI (n = 18), and their parents were recruited from three tertiary hospitals in Brisbane and Melbourne, Australia. Parents provided retrospective ratings of their child’s pre-injury PCS, HRQOL, and their own pre-injury subjective distress within six weeks of their child’s mTBI. The above measures, as well as children’s self-reported psychological distress and objective measures of children’s cognitive functioning were administered at six and 18 months post-mTBI. Analyses showed that children with complicated mTBI had 2 - 3 PCS, and children with uncomplicated mTBI had 4 PCS throughout the follow-up period. The frequency of post-mTBI PCS did not differ from the pre-injury frequency of PCS. At six months post-mTBI increased paediatric PCS were predicted by higher pre-injury parent distress, increased frequency of pre-injury PCS, and mTBI severity. At 18 months post-mTBI, increased paediatric PCS were predicted by higher pre-injury parent anxiety, higher frequency of pre-injury PCS, and poorer pre-injury paediatric HRQOL. The adverse impact of pre-injury parent distress (hyperarousal symptoms and general anxiety) on children’s PCS decreased between six and 18 months post-mTBI. As a significant proportion of children with uncomplicated mTBI did not undergo neuroimaging, the above analyses were repeated after recoding mTBI severity into three groups; mTBI (no imaging), uncomplicated mTBI (confirmed by imaging), and complicated mTBI. The findings of the re-analyses were similar to the above findings with the following exceptions; at six months post-injury, mTBI severity did not predict PCS. In addition, the relative impact of high levels of pre-injury parent hyperarousal symptoms, but not general anxiety on paediatric PCS, decreased between six and 18 months post-mTBI. These findings highlight the importance of identifying and addressing parent’s pre-injury distress and poorer pre-injury paediatric HRQOL, in order to improve children’s PCS. Suggestions for future research are provided. Chapter 3 aimed to review and evaluate interventions for paediatric PCS. The findings of the literature review indicated that parent and child psychoeducation resources aimed at promoting recovery would likely be effective at reducing adverse post-mTBI outcomes (e.g., PCS, psychological distress) (e.g., Kirkwood et al., 2007; Ponsford et al., 2001; Ponsford et al., 2002). Parents and children with uncomplicated mTBI were recruited from the Royal Children’s Hospital in Brisbane, Australia. Families completed a baseline (within two weeks post-injury) and three month follow-up assessment of parent and child psychological functioning and HRQOL, as well as children’s cognitive functioning and PCS. After the baseline assessment children and their parents were randomly assigned to the prevention group (n = 5) or wait list control (WLC; n = 5). The analyses suggested that the psychoeducation resources were associated with improvements in children’s speed of information processing, verbal learning and recall, and physical HRQOL, as well as decreased parental anxiety, relative to the WLC. There were no significant between group differences with regard to PCS, however the prevention group demonstrated a trend towards increased somatic PCS at post-treatment relative to their pre-treatment ratings. Parents and children rated the psychoeducation resources as easy to read and helpful. Parent’s feedback also suggested that the psychoeducation resources addressed their support/-reassurance and information needs. These findings suggest that the psychoeducation resources are likely to be effective at improving parent’s and children’s post-mTBI outcomes. Higher somatic PCS in the prevention group may be an effect of the small sample size or reflect an effect of parent’s increased awareness of, and hypervigilance to somatic PCS. Chapter 4 provides an integrated discussion of the key findings of this thesis. It is concluded that parent’s functioning is an important determinant of children’s post-mTBI functioning and PCS. Also, the post-mTBI functioning of parents and children can be improved via cost-effective psychoeducation targeted at both parents and children.

Peer rejection and social and emotional behavioural difficulties : can self-regulation promote acceptance

Lynn, Sasha — 2012-12-12T00:00:00Z

Perceived Effectiveness of Behaviour Control Strategies in Primary School Children Suspended or Excluded from School: The Development and Evaluation of a Scale

Penelope Mackay — 2010-05-19T00:00:00Z

Abstract Disruptive behaviour in primary school can predict life-course persistent antisocial behaviour and criminal convictions in adulthood. The longer these behaviours are left untreated the more difficult it becomes to modify this life course trajectory. Discipline strategies such as school suspensions and/or exclusions have proved largely unsuccessful in modifying childhood antisocial behaviour. Evidence suggests that children with antisocial behaviour lack certain social and life skills and behavioural control strategies and it is these skills and strategies that are typically included in interventions targeting this population. One area that has yet to be investigated is whether the children themselves perceive these skills and strategies to be effective in helping them to control their own behaviour. This area represents a gap in our understanding of antisocial behaviour and could potentially lead to improved interventions for these children. The aim of the present research was to develop a scale that could record child ratings of the usefulness of specific strategies that are often used to control the behaviour of children who are at-risk of being suspended and/or excluded from school. The research comprised three studies. Study One involved the development of the measure through a review of the literature on behavioural control strategies and social and life skills and individual interviews with 13 specialist behaviour staff from schools throughout Queensland. Study Two consisted of piloting the scale with 13 students aged 10 to 13 years. An item affectivity and discrimination analysis was conducted to revise and reduce the items of the scale. Study Three provided a validation of the scale using 74 students who had been suspended or excluded from 24 Queensland state schools. Findings revealed the scale had adequate reliability and validity. A factor analysis revealed a four factor underlying structure with Conflict Resolution, Behaviour Management Consequences, Self-Esteem and Empathy outlining the skill areas. Social and conflict resolution skills were rated as the most useful by children to help manage their behaviour in school. The findings of this research are discussed in the context of current understandings of antisocial behaviour. Limitations, clinical implications and directions for future research are highlighted.

Personality Influences on an Acceptance-Based Relapse Prevention Program for Alcohol Dependence

Yolanda Gribble — 2012-12-20T00:00:00Z

Alcohol dependence is a difficult to treat condition where relapse rates are often high. In response to this, acceptance-based therapies are gaining clinical popularity in the relapse prevention field despite a lack of robust research base exploring proposed mechanisms of change. This study aimed to explore how a neurobiologically derived personality theory, Gray’s Reinforcement Sensitivity Theory (RST), explained individual differences in key acceptance-based variables throughout treatment following detoxification in an alcohol-dependent inpatient population. Fifty-two substance dependents were followed during an acceptance-based relapse prevention program and at one-month posttreatment. Use of a latent growth curve model found that mindfulness, acceptance and valued living increased throughout the program. Rates of change and baseline levels of these acceptance-based variables were significantly predicted by several personality factors, including behavioural inhibition, behavioural activation, rash impulsivity, fight and freeze. No significant effects were found at follow-up due to a lack of adequate power. These preliminary findings suggest that an acceptance-based therapy applied to relapse prevention operated in accordance with theoretical specifications. Further, RST served as a useful framework for conceptualising individual differences before and during treatment in a substance dependent population. Future research may use such information to consider the effectiveness of administering personality-tailored interventions in a clinical population.

Posttraumatic Growth and Psychological and Behavioural Adjustment in Thyroid Cancer Survivors

Ms Rachel Costa — 2009-10-28T00:00:00Z

The objectives of the current research were two fold, firstly to expand the current knowledge and understanding of psychological functioning of thyroid cancer patients, especially with regard to positive psychological states including posttraumatic growth (PTG), and secondly to extend the understanding of PTG in relation to psychological adjustment in cancer more broadly by addressing methodological and conceptual criticisms of previous research. Two studies derived from the one research methodology were conducted: Study 1 documented a comprehensive psychosocial profile of thyroid cancer patients and Study 2 examined relations between PTG and adjustment. In Study 2 it was predicted that greater PTG would be related to increases in all of the positive adjustment indicators including positive affect, positive health behaviour changes and higher order adjustment (purpose in life, self-acceptance, spiritual wellbeing and wisdom). Self-reported health behaviour change was also examined as a source of validity for PTG and partner reports of participants’ PTG and health behaviour change were investigated as potential sources of external validity for these measures. Participants for both studies were 154 out-patients (mean age = 50.96 years, SD = 14.43) being treated for thyroid cancer at a large, tertiary, metropolitan hospital, and 34 partners. Most thyroid cancer participants were female (n = 108). Results of Study 1 provided a psychosocial profile of thyroid cancer patients that is more comprehensive than has previously been performed and that included both positive and negative psychological sequelae in response to the experience of cancer. The majority of participants fell within the normal range for depression (91.6%), while over a third (38.3%) were in the clinical range for anxiety and almost half (44.4%) met criteria for DSM-IV trauma. In comparison with prior research on thyroid cancer patients, participants of the present study revealed similar levels of anxiety and similar or lower levels of depression. Overall stress and trauma associated with the cancer experience was lower for participants of the present research than that reported in previous breast cancer research. Positive adjustment indicators including PTG, purpose in life, self-acceptance, and spiritual wellbeing were reported at similar levels to that of previous research involving cancer patients, and positive affect was relatively high compared with community norms. A number of sociodemographic factors including, age, sex, income and marital status and only one illness variable, cancer stage, was significantly related to psychological adjustment outcomes. Results for Study 2 supported predictions. After controlling for relevant sociodemographic variables and cancer-related stress, PTG predicted positive affect and two out of four of the higher order adjustment outcomes, spiritual wellbeing and wisdom but not purpose in life and self-acceptance, as well as positive health-related lifestyle changes. PTG was not significantly related to anxiety or depression. Measures of health behaviour change provided some validation for PTG supporting the contention that PTG reflects veridical growth. The present research provided a comprehensive profile of psychological functioning in thyroid cancer patients in comparison to other research samples of participants with thyroid and other cancer types, as well as identifying sociodemographic and illness-related variables that were relevant to psychological adjustment. In addition, the adaptive significance of PTG was demonstrated and there was some support for PTG reflecting veridical change. The present research provided support for a number of the theoretical contentions associated with PTG including that PTG may coexist with distress, that PTG is more likely to reflect positive adjustment outcomes, and that a broader definition of adjustment is warranted in the context of PTG. The present research also extended the understanding of PTG in the adjustment to cancer by identifying aspects of higher order adjustment associated with PTG and by demonstrating the validity and efficacy of a measure of PTG that accounts for both positive and negative changes in a cancer population. Finally, some important clinical implications are outlined for screening and psychological follow-up of thyroid cancer patients and considerations for the clinical application of PTG are offered, followed by directions for future research.

Posttraumatic Stress, Depression, Anxiety and Stress in Mothers of Children Discharged from Paediatric Intensive Care Unit (PICU)

Huang Shuhui Cheryl — 2012-04-11T00:00:00Z

When children are admitted into Paediatric Intensive Care Units (PICU), the circumstances surrounding the admission can be extremely stressful for their parents. As such, parents may experience emotional distress that can persist after their child’s discharge. This study, is part of a larger study that examined medical traumatic stress in PICU children and their parents. This study will examine various maternal, child and PICU treatment characteristics that contribute to maternal posttraumatic stress, depression, anxiety, and stress following PICU admissions. One hundred and forty-two mothers of PICU survivors, aged 3 to 17 completed questionnaires immediately after their child’s discharge from PICU (T1). Immediately after their child’s discharge from PICU (T1), 41.1% of the mothers reported experiencing moderate to severe posttraumatic stress. Between 17.6% and 22.5% of the mothers also reported elevated levels of depression, anxiety and stress. Maternal perception of treatment intensity, maternal premorbid physical health, maternal perception of threat to child’s life, and child’s posttraumatic stress were found to be factors associated with all measures of maternal emotional distress at T1. At three months post-discharge (T2), a significant reduction on all measures of maternal emotional distress was found. Child’s posttraumatic stress at T1 was found to predict maternal posttraumatic stress at T2 and child’s exposure to distressing events in PICU was found to predict maternal anxiety at T2. At six months post-discharge (T3), no further reduction was found on all measures of maternal emotional distress. In addition, none of the study’s variables predicted maternal emotional distress at T3. At T2 and T3, there were mothers who reported moderate to severe posttraumatic stress even though they were unlikely to meet diagnostic criteria for post-traumatic stress disorder. A child’s admission into PICU is a stressful event for parents. Immediately after their child’s discharge from PICU, posttraumatic stress is common amongst mothers (41.1%). Maternal depression (18.3%), anxiety (17.6%) and stress (22.5%) were also found in about a fifth of the mothers. Although, a significant reduction on all measures of maternal emotional distress was found at 3 months post-discharge, follow-up care is warranted and treatment should not end after discharge. In addition, support for mothers should not be limited only to those who meet diagnostic criteria as there are mothers who experience moderate to severe levels of distress even though they were unlikely to meet diagnostic criteria for post-traumatic stress disorder. Research should focus on reducing parental emotional distress so that their ability to care for their recovering child is not compromised.

Practice-Based Evidence: An Evaluation of the ATAPS and Better Access Initiatives by the Australian Government at the Ipswich & West Moreton Psychology Clinic

Miss Kristy Sippel — 2012-11-15T00:00:00Z

While potentially effective psychological treatments have been developed to assist many who experience mental health problems, relatively few people with such problems access care, and socially disadvantaged groups are particularly unlikely to access care. The current study assessed the reach of a clinical service providing psychological treatment to the population of an outer urban area of Brisbane, Australia that has a high representation of social disadvantage. It also assessed the clinical outcomes for 365 consecutive client presentations to the service, with all presentations being made as referrals from each client’s doctor under schemes designed to enhance access to psychological treatment. A large proportion of the referred clients did not attend treatment following referral from their doctor, or if they did, it was only for one session. Of the clients who did remain in treatment, a large proportion recovered and made reliable change throughout treatment, such that they were no longer classified as clinical cases at treatment completion. However, some of the groups who identify as hard to reach (in particular, young people under 15 years old and men) used the service at a lower rate and therefore failed to benefit from a service they needed and could have been accessing. Recommendations for methods to retain more referrals were given, which undoubtedly have significant policy and service reform implications if equitable access to high-quality mental health care services is to be achieved.

Prevalence of Physical Activity and Its Association with Self-Reported Memory: Findings from the Australian Longitudinal Study on Women's Health

Ms Yirui Wang — 2013-02-21T17:39:48Z

This research examined the prevalence of physical activity (PA) and sedentary behaviour (i.e., prolonged sitting) in a sample of 5470 middle-aged Australian women. It also explored the relationship between PA and memory complaints. Respondents were randomly selected from the Medicare national health insurance database for the Australian Longitudinal Study on Women’s Health. For this research, data collected at the surveys in 2004, 2007 and 2010 were used. Participants included a large, national sample of community-dwelling, relatively healthy women who reported no difficulty walking 100 meters and had no missing values on the main outcome or explanatory variables at each survey. The results indicated that a substantial proportion of the middle-aged Australian women achieved or exceeded the recommended 150 minutes per week of moderate-intensity PA (64.3% in 2004, 68.2% in 2007, and 65.7% in 2010). Contrary to expectation, the self-reported levels of leisure/transport PA increased from 2004 to 2010. Further investigation revealed that women with low education, low socio-economic status, high body mass index (BMI), and smokers may be less likely to meet the recommendation. The average sitting time among these women was high (42.6 hours per week in 2004, 45.8 hours per week in 2007, and 45.1 hours per week in 2010). Working women reported longer average sitting times and non-working women, and women with high BMI reported longer sitting times than those with low BMI. The cross-sectional analyses indicated that a higher level of total PA (including leisure/transport and intense domestic PA) was associated with a lower rate of perceived decline in memory function. The association remained true following adjustment for a number of confounding variables in two of the three surveys. The research highlights the need for more empirical work, especially intervention studies, to understand the complex relationships between PA and memory complaints.

Problems faced by African refugee women during resettlement in Toowoomba, Australia

Mrs Dianne Henderson — 2012-06-24T00:00:00Z

This qualitative study investigates the issues encountered by refugee women as they resettle in the regional centre of Toowoomba, Queensland, Australia. The city, in the Darling Downs region of Southeast Queensland, was designated by the Australian Government as a regional resettlement destination for African refugees in the mid-nineties. Refugees from Southern Sudan were the main group to be supported at this time. Its rural location in reasonable proximity to a capital city, affordable housing, relatively positive employment prospects and provision of a variety of services and facilities made it an appropriate choice for refugee resettlement. The investigation is centred on questions relating to three areas: the identification by the refugee women of their most significant resettlement issues; the role of age, ethnicity, education and length of time in Australia within the identification process; and possible points of comparison between key issues emerging in Toowoomba and those in some other local areas. In view of the fact that the Australian Government’s original humanitarian focus in Toowoomba was the resettlement of Sudanese refugees, the majority of the participants of this study are Southern Sudanese. There are small representations from Liberia, Burundi and the Democratic Republic of Congo. Data were collected from eighteen women in two different age categories, under and over forty years, and who had been in Australia for two different time periods, less and more than two years. Methods of data collection included focus groups, semi-structured interviews and participant observation. The focus groups were conducted at the outset of the study in order to introduce the women to the researcher and from which eighteen women were later selected. These group discussions took place at the TRAMS Centre (Toowoomba Refugee and Migrant Services). Individual interviews with the women and TRAMS Co-ordinator were held at TRAMS and in the homes of some interviewees. Participants were purposefully selected according to their English language ability so that translation problems were minimised. Findings indicated that acquiring language skills, finding employment and securing housing were the issues identified as most significant by all participants. Learning the language was regarded as most significant with all of the women highly motivated to become proficient in reading, speaking and writing English. Most of them believed that the period of Government funded instruction was far too short and were grateful to TRAMS for providing further learning opportunities. The desire for employment proved to be the most dominant motivation for learning the language but it was also believed that a sound knowledge of English was essential for personal development and social inclusion. Nearly three quarters of the respondents rated the search for work as one of the three most significant challenges. Most of the remainder did not wish to work outside the home at this stage because of their young families. Key factors emerging were their low expectations in relation to the type of work available to them, the difficulty of obtaining specific qualifications which may broaden their choices beyond manual work and, in some cases, the prejudice that they perceived from potential employers. Most felt that a better grasp of the English language would assist in all of these areas, although some sensed that employers in Toowoomba underestimated the strength of the African work ethic. Just over a quarter of the women rated finding a home a major issue. The TRAMS Co-ordinator and the women most affected believed this to be a result of the small amount of rental accommodation available in Toowoomba, the lack of a tenancy record with which to re-assure landlords and real estate agents, and the costs involved. Other important issues which arose from the interview sessions related to relationship building in the new environment, their children’s futures, members of their family left behind in camps or the home country and the trauma of the pre-migration period. Age, ethnicity, educational background and length of time in Australia were all found to be significant in the identification process, although not all factors influenced all of the challenges that were nominated. Similar major problems were identified by refugees in other projects in Australia, each organization dealing with the issues according to the needs and resources of their situation. Findings of the study are discussed within the social healing and social capital theoretical frameworks, and the role of TRAMS in the process of healing and the development of refugee social capital is evidenced. As a consequence, the participants of this investigation, through their involvement with TRAMS, are positioned to be effectively progressed on their journey towards resettlement.

Psychological Adjustment of Asian-Indians as a function of Acculturation Style, Generational Status, and the 'Acculturation Gap'

Miss Kiranpal Sangha — 2010-04-17T00:00:00Z

This study examined the relationship between the acculturation styles of first-generation and second-generation Asian-Indians residing in Australia and their psychological adaptation. An additional purpose of the study was to examine the validity of the ‘acculturation gap-distress hypothesis’ in an Indian population. One hundred and fifty-one Asian-Indians (51 first-generation Indians and 99 second-generation Indians), aged between 16 and 29 years were recruited from universities and Indian organizations using a snowball sampling method. Participants completed a questionnaire measuring acculturation styles, perceived parental acculturation styles, parent-child conflict, depression, anxiety, stress, somatization, alcohol use, and subjective well-being. As expected, the integrated style of acculturation was the most preferred strategy adopted by Indians, followed by the separated acculturation style. Also consistent with expectations, second-generation Asian-Indians were more likely to endorse an integrated style of acculturation compared to first-generation Asian-Indians who were more likely to demonstrate a separated style of acculturation. No significant differences in psychological adaptation were revealed between first- and second-generation Asian-Indians, and furthermore, there were no significant differences in levels of psychological adaptation as a function of acculturation style. However, the results did provide support for the acculturation gap-distress hypothesis, revealing that in those Indian families in which an acculturation gap was present, parent-child conflict was significantly greater, and levels of subjective well-being of second-generation Indians were significantly lower. In addition, higher levels of parent-child conflict were associated with higher levels of depression, anxiety, stress and somatization, and lower levels of subjective-well being. The results suggest that an integrated style of acculturation is not necessarily associated with superior psychological outcomes amongst Indians in Australia, as previously claimed by researchers. The findings also highlight the potentially significant role of intergenerational conflict in the psychological adaptation of second-generation Indians residing in Australia.

Psychologist Empathy and Couple Relationship Education Outcomes

Louise Williams — 2012-03-08T00:00:00Z

Therapist empathy predicts better outcome in individual therapy and marital and family therapy (MFT). Couple Relationship Education (CRE) is early intervention intended to strengthen couple relationships and prevent future relationship problems. However, there is almost no research on whether empathy is associated with CRE outcomes. Eighty-eight participants (44 couples) were randomly assigned to receive RELATE or RELATE with Couple CARE. RELATE consisted of the completion of an inventory assessing couple relationship strengths and challenges plus a feedback session to discuss the relationship and identify goals for relationship enhancement. The RELATE with Couple CARE condition involved completing the same inventory and feedback session plus the six-session, relationship skills training Couple CARE program. Recordings of samples of sessions were rated to assess educator empathy towards both members of the couple. Multilevel model analyses found there was no relationship between therapist empathy and change in women or men’s relationship satisfaction. However, there was a trend for men’s initial relationship satisfaction to predict educator empathy in the RELATE with Couple CARE condition. It is possible that empathy is easier to demonstrate towards men who are initially more satisfied with their relationship, than men who are less satisfied. Implications for psychological practice and future research are discussed with a particular focus on the importance of empathy when conducting a CRE program.

Relationships between health and lifestyle factors and executive functioning with advancing age

Currell, Matthew — 2011-11-04T00:00:00Z

Reversal Learning and Couple Relationships

Richard Wellauer — 2012-11-15T00:00:00Z

Cognitive flexibility is an executive function that represents the ability to adapt behaviours according to feedback from the environment, and is related to the function of the ventral prefrontal cortex (Clark, Cools, & Robbins, 2004). Previous research shows that cognitive flexibility influences social functioning, but this has not yet been examined in the context of couple relationships (Kringelbach & Rolls, 2003). The aim of the current research project is to examine the role of cognitive flexibility in couple relationships. Participants were 42 couples recruited through online and newspaper advertisements. They completed the Couples Satisfaction Index and a reversal learning task (a measure of cognitive flexibility) over the internet, and participated in a problem-solving discussion task. Couples were then randomly assigned to one of three couple relationship education programs, after which they completed the Couple Satisfaction Index for a second time. Consistent with hypotheses, people with better reversal learning were more likely to have partners that were more satisfied, however, this association was only present for happy couples, not unhappy couples. Unexpectedly, reversal learning performance was not associated with the frequency of positive and negative behaviours and affect during problem-solving discussions, however, exploratory analyses showed that associations were in the expected direction. Due to problems with missing data and attrition, there was insufficient power to test whether reversal learning predicted change in relationship satisfaction after couple relationship education. This study provided preliminary evidence that reversal learning is related to outcomes for couples, and suggests that happy and unhappy couples use their cognitive abilities in different ways. Further research would benefit from increased experimental control and a larger sample size.

Social Problem Solving Inventory - Revised Short Form (SPSI-R:S): An evaluation of its psychometric properties and predictive capacity with a young adolescent population

Miss Claire Gisele Easton — 2010-02-17T00:00:00Z

Abstract The term social problem solving refers to problem solving as it occurs in the real world. It has been defined as the self-directed cognitive-behavioural process by which a person attempts to discover effective ways of coping with challenging situations encountered in the course of everyday life (D'Zurilla & Nezu, 1999). Substantial research has documented the important role that social problem solving plays in the management of life stressors and subsequent development of psychopathology. Past research highlights the strong link between the ability to cope with or resolve everyday stressful events and an individual’s personal or social functioning (D'Zurilla & Nezu, 2001). The primary goal of this thesis was to review the measurement and clinical utility of this construct in terms of a young, Australian adolescent population. In order to achieve this aim, a large sample was used to conduct novel analyses in two separate studies. The first study revealed the Social Problem Solving Inventory – Revised: Short Form (SPSI-R:S) to be a sound measure for use with an adolescent population. Results of a subsequent evaluation of the measure’s psychometric properties provided strong support for internal consistency reliability and adequate temporal stability. Additionally, structural, concurrent and predictive validity where shown. Overall, the SPSI-R:S performed well and was found to be a time-efficient, reliable and valid instrument for the assessment of social problem solving among young, Australian adolescents. The aim of the second study was to evaluate the predictive capacity of the SPSI-R:S. This entailed an examination of the relationship between social problem solving and adverse life events on the psychological functioning of young adolescents. Specifically, it examined a moderation model of this relationship predicting internalising and externalising factors, both cross-sectionally and over time. The results showed that in the presence of either higher or lower levels of life stress, social problem solving (as measured by the problem solving orientation subscales of the SPSI-R:S) is a moderating factor, which can exacerbate or attenuate the likelihood of developing depressive symptomatology, both cross-sectionally and over time. It was also found that, in the presence of either higher or lower levels of life stress, social problem solving (as measured by the negative problem solving orientation subscale of the SPSI-R:S) moderates the likelihood of developing externalising symptoms over time, but not in the shorter term. These results, taken together with the identified stronger direct relationship between problem solving and both internalising and externalising symptoms (crosssectionally and when examining predictions over a one-year period) underline the importance of problem solving orientation as a predictor of psychopathology in both male and female adolescents. Overall, results support the suggestion that problem solving orientation may play a role in the development of depressive symptoms over time. Strengths and limitations of the study are noted and both implications for clinical use and future research are discussed.

Surviving Multiples: An Evaluation of a Group Behavioural Parenting Intervention for Parents of Twins and Triplets

Ms Samantha Brown — 2010-10-29T00:00:00Z

An increasing number of families are facing the unique challenge of parenting twins and triplets, yet there are few specific services available for them. Emerging research indicates that parents of multiples are at greater risk of experiencing parenting stress and displaying compromised parenting practices, while the children themselves maybe at increased risk of emotional and behavioural problems. The primary aim of the present study was to evaluate the efficacy of a tailored Group Triple P – Positive Parenting Program for parents of twins and triplets aged between 18 months and 6 years. The present study was the first randomised controlled evaluation of a behavioural parenting skills program with parents of multiples. Sixty-seven parents of multiples were randomly assigned to either Surviving Multiples Group Triple P (SMGTP) (N=35) or a waitlist control condition (N=32). There were significant effects of intervention demonstrated at post intervention and six months follow-up for parent reports of child behaviour, parenting style, strategy use, global and specific parenting confidence, parenting satisfaction, and parental stress. Parents in the intervention condition when compared to the control condition, showed not only statistically significant improvements, but the changes were also reliable. Parents in the intervention condition also demonstrated significant shifts into the normative range from the clinical range on a number of measures. While the majority of hypotheses were supported, parent perception of social support did not change across conditions. This study demonstrates that a tailored behavioural parenting group is effective and highly acceptable for parents of young multiples which could be offered to families to address the current lack of multiples-specific parenting services available in the community.

"Temperament and character dimesions of personality : a mediated model of delinquency"

Lane, Adam — 2012-12-13T00:00:00Z

The acute care ward experience for dementia patients and their caregivers

Mrs Linda Hollis — 2011-08-16T00:00:00Z

Acute hospitalisation of persons with dementia can be a distressing experience for both the person with dementia and their caregiver, and is frequently a catalyst for the transition to residential care. Schözel-Dorenbos, Meeuwsen, and Olde Rikkert’s (2010) Hierarchy Model of Needs in Dementia, relating to the unmet needs of persons with dementia and their caregivers, was used to guide this study. All persons aged 70 years and over presenting to four acute care wards in and around Brisbane, and their caregivers, were approached to participate in this study. A qualitative analysis was conducted of pre and post-hospital stay survey data obtained from caregivers of persons with dementia (n = 25) and caregivers of persons without dementia (n = 80). Quantitative analysis was performed on data from assessment measures for persons with dementia (n = 96) and persons without dementia (n = 386) admitted to the acute care ward. The results for the qualitative analysis showed that caregivers’ most prominent concern was to maintain the dignity of their care recipient, and that many caregivers found the attitude of staff to be inappropriate. Issues surrounding discharge and the transition to residential care were also highlighted. The quantitative results revealed that persons with dementia scored more highly than persons without dementia on measures relating to cognitive decline, behavioural and psychological symptoms of dementia, and depression, and were more likely to have a longer hospital stay. Unexpectedly, they did not score more highly than persons without dementia in relation to decline in activities of daily living from admission to discharge, on a measure relating to vulnerable elders, or in the number of falls experienced during the hospital stay. Delirium was less likely to be resolved on discharge in persons with dementia, but persons with dementia were no more likely to have delirium on admission or during the hospital stay than persons without dementia. Documentation of the results of assessment measures was higher than expected for the Mini-Mental State Examination and the Confusion Assessment Method, but results for measures requiring caregivers’ input, that is, The Informant Questionnaire on Cognitive Decline in the Elderly and the Neuropsychiatric Inventory Questionnaire, were more likely to be absent from patients’ records. Assessment of depression was performed significantly less frequently in persons with dementia than in persons without dementia. Findings are considered with reference to the needs of persons with dementia and their caregivers, and also the potential role for geropsychologists in ensuring that these needs are met. Geropsychologists may contribute by providing education and training to staff, as well as support to staff, caregivers, and the person with dementia. Accuracy of diagnoses may also be enhanced by geropsychologists skilled in differential diagnoses of older adults.

The acute care ward experience for persons with dementia and their caregivers

Hollis, Linda — 2011-08-16T00:00:00Z

Acute hospitalisation of persons with dementia can be a distressing experience for both the person with dementia and their caregiver, and is frequently a catalyst for the transition to residential care. Schözel-Dorenbos, Meeuwsen, and Olde Rikkert’s (2010) Hierarchy Model of Needs in Dementia, relating to the unmet needs of persons with dementia and their caregivers, was used to guide this study. All persons aged 70 years and over presenting to four acute care wards in and around Brisbane, and their caregivers, were approached to participate in this study. A qualitative analysis was conducted of pre and post-hospital stay survey data obtained from caregivers of persons with dementia (n = 25) and caregivers of persons without dementia (n = 80). Quantitative analysis was performed on data from assessment measures for persons with dementia (n = 96) and persons without dementia (n = 386) admitted to the acute care ward. The results for the qualitative analysis showed that caregivers’ most prominent concern was to maintain the dignity of their care recipient, and that many caregivers found the attitude of staff to be inappropriate. Issues surrounding discharge and the transition to residential care were also highlighted. The quantitative results revealed that persons with dementia scored more highly than persons without dementia on measures relating to cognitive decline, behavioural and psychological symptoms of dementia, and depression, and were more likely to have a longer hospital stay. Unexpectedly, they did not score more highly than persons without dementia in relation to decline in activities of daily living from admission to discharge, on a measure relating to vulnerable elders, or in the number of falls experienced during the hospital stay. Delirium was less likely to resolved on discharge in persons with dementia, but persons with dementia were no more likely to have delirium on admission or during the hospital stay than persons without dementia. Documentation of the results of assessment measures was higher than expected for the Mini-Mental State Examination and the Confusion Assessment Method, but results for measures requiring caregivers’ input, that is, The Informant Questionnaire on Cognitive Decline in the Elderly and the Neuropsychiatric Inventory Questionnaire, were more likely to be absent from patients’ records. Assessment of depression was performed significantly less frequently in persons with dementia than in persons without dementia. Findings are considered with reference to the needs of persons with dementia and their caregivers, and also the potential role for geropsychologists in ensuring that these needs are met. Geropsychologists may contribute by providing education and training to staff, as well as support to staff, caregivers, and the person with dementia. Accuracy of diagnoses may also be enhanced by geropsychologists skilled in differential diagnoses of older adults.

The Anxiety Sensitivity Index-3 in alcohol dependent adults: Psychometric validation and utility in predicting medium term drinking outcomes

Miss Michelle Engels — 2010-11-23T00:00:00Z

The current thesis describes two studies of anxiety sensitivity in individuals with disordered alcohol use. Study one was designed to validate the empirically derived three-factor structure of the Anxiety Sensitivity Index-3 (ASI-3) within a sample of adults entering treatment for alcohol misuse. The aim of study two was to investigate the predictive utility of anxiety sensitivity and drinking expectancies in relation to drinking outcomes following treatment for alcohol misuse. In particular it was hypothesised that drinking expectancies would mediate the relationship between negative affect and drinking following treatment, whereas anxiety sensitivity would moderate this relationship. One hundred and twenty-eight participants were recruited from five private and public drug and alcohol treatment centres throughout the South-East Queensland region. At admission, discharge, and three-months post-discharge the assessment battery was administered which included, the ASI-3, measures of anxiety, depression, and stress, drinking expectancies and drink refusal self efficacy. Results of study 1 revealed the ASI-3 was best represented by a hierarchical three-factor structure, with one overall AS higher-order domain. Results of study 2 failed to support the proposed moderated-mediation model. However the effect of the moderator (AS), on the dependent variable, days to lapse as measured at the three-month follow-up, was found to depend on the mediator (DE), but this result was independent of the measure of anxiety symptoms. The clinical implications of these finding are discussed, and suggestions for future research made. Overall, the results show that anxiety sensitivity is high in adults entering treatment for alcohol misuse yet it improves markedly with treatment. Furthermore, it was found that participants who remained high in anxiety sensitivity at the end of treatment were prone to relapse at an earlier stage once discharged from treatment. The results aim to inform the development of future intervention programs that may protect against relapse, whilst establishing a clinically validated outcome measurement.

The application of cognitive behaviour therapy to treat anxiety and depression in people with intellectual and/or developmental disabilities with concomitant mental health disorders

Hatzipetrou, Loukas — 2012-04-19T00:00:00Z

The Brisbane Storms Project: A Naturalistic Study of the Impact of Parenting Factors on Post Traumatic Stress Disorder in Children following a Natural Disaster

Miss Megan Newrick — 2010-07-31T00:00:00Z

Research has suggested that exposure to a natural disaster (e.g., hurricanes, earthquakes or floods) in youth is associated with a number of different post traumatic emotional reactions, including symptoms of post traumatic stress disorder (PTSD) and other anxiety disorders (La Greca & Silverman, 2006). Past research has identified the important role which parenting plays in the development of child post traumatic stress disorder (Nickerson, Reeves, Brock & Jimerson, 2009; Terranova, Boxer & Sheffield-Morris, 2009); however, little research has specifically investigated the impact that parenting factors, including parental psychopathology and changes in parenting practices, may have on child post traumatic stress disorder following a natural disaster. Following a severe storm which occurred in The Gap, Brisbane, in November, 2008, a sample of children in Grades 4-7 (N=680) at a number of state and Catholic schools were screened for post traumatic symptomatology using the Child Trauma Screening Questionnaire (CTSQ) as part of a government-based health initiative. Parents were also given a questionnaire to complete. This study aimed to investigate the relationship between parental psychopathology on child post traumatic symptomatology and the relationship between parenting factors and child PTSD. Results from a logistic regression analysis showed that the most significant predictor of children being in the clinical range on the CTSQ was if they reported that they thought they were “going to die” during the storm. A number of other exposure-related predictors were also found to be significant. Results showed that the predictor of changes in parenting since the storm as measured by the parenting measure total score was also significant, indicating that an increase of every one unit in the total score related to children being 1.19 times more likely to be in the clinical range on the CTSQ. This indicates that parents who reported changes in their parenting, including becoming more overprotective or avoidant, were significantly more likely to have children who reported experiencing PTSD symptomatology. The predictor of parental psychopathology (the K6) was not significant, indicating that parents who reported experiencing distress and psychopathology since the storms were not significantly more likely to have children who reported PTSD symptomatology. It is hypothesised that this was likely to be due to the fact that the sample consisted of children aged 8 to 12, and research has suggested that the impact of parental distress and psychopathology following a traumatic event is the most salient in younger children, due to their greater dependence on caregivers (Laor et al., 1996). Limitations of this study and directions for future research are discussed.

The Construction and Evaluation of Three Affection Measures for Children with Asperger's syndrome

Ms Jessica Lee — 2009-09-15T00:00:00Z

Children with Asperger’s syndrome are often reported in clinical settings by their parents as having difficulties communicating affection. This study aimed to develop a valid measure of affection that could be used to investigate these anecdotal reports and then be used in further intervention research. Three measures: the Affection for Others Questionnaire, Affection for You Questionnaire and General Affection Questionnaire, were developed with reference to the existing affection literature and through the use of parent and expert focus groups. The measures were completed by 126 parents of children with a clinician confirmed diagnosis of Asperger’s syndrome. Analyses of the measures revealed clear factor structures with high internal consistencies and significant concurrent validities. The findings suggest that many children with Asperger’s syndrome have difficulties with affection that significantly impact on their daily functioning and their relationships with others and that future research is needed to develop interventions in this area.

The Coping with Caring Program: a self-directed, evidence-based correspondence intervention for carers of older people with dementia

Zoe L. Barnett — 2012-04-02T00:00:00Z

The Coping With Caring Program (CWCP) is an innovative, self-directed correspondence program to treat mood and stress symptoms in carers of older people with dementia. It is an evidence-based, multiple component intervention consisting of eight weekly workbooks designed to address the most common challenges faced by dementia carers. This research investigated whether a self-directed program such as the CWCP, which consists of workbooks delivered via post, is sufficient to reduce the risk factors associated with the development of emotional and psychological problems in carers, and enhance carers’ self efficacy and coping skills. The CWCP builds on the work of an existing multiple component community treatment program Enhancing Alzheimer’s Caregiver Health (REACH), which improved feelings of burden, increased social support and reduced depression in dementia carers (Burgio et al., 2009). The key difference of the CWCP is the use of a self-directed, correspondence-based intervention to address the negative symptoms associated with caring. Specifically, the aim of this body of research was to develop a multiple component intervention containing the elements necessary to meet the needs of carers in a self-directed correspondence format. Further, the present research sought to assess the efficacy of a self-directed correspondence intervention to reduce negative symptoms such as burden, low mood and anxiety, whilst improving problem solving and coping skills in dementia carers. Participants were 34 Queenslanders (Men = 9, Women=25) caring for a family member with moderate stage dementia. The mean age of participants was 68 years. Participants were recruited through advertising in newsletters, flyers, community papers, public noticeboards and websites, and through presentations to dementia associations and ageing interest groups. Participants were randomly assigned to one of two conditions (1) CWCP: a self-directed, correspondence intervention consisting of eight weekly workbooks and minimal telephone support or (2) Waitlist control: a comparison group who received educational, information only newsletters. When each condition was completed, participants then crossed over to complete the alternate condition. There were a number of improvements at post intervention. Carers reported improvements in care recipient behaviour and levels of sadness and irritation post treatment. Further, the results indicated significant improvements in participants’ overall affect and on subjective measures of hopelessness, happiness, and perceptions of feeling in control post treatment compared to the waitlist control condition. There were no significant effects at post intervention on objective measures of burden, depression, anxiety, strain or perceived positive aspects of care giving. This research provides important information regarding the viability of a self-directed, multiple component correspondence intervention as a treatment protocol for carers of persons with dementia experiencing emotional and psychological stressors. Further, the findings suggest the CWCP could be an effective, practical and inexpensive treatment solution with the potential for widespread dissemination. Potential reasons for the lack of treatment effects are discussed, along with implications for future research.

The development of a brief Functional Magnetic Resonance Imaging test battery for neurofunctional investigation of language, memory encoding and motor function in normal children

Miss Christina Sveller — 2009-06-22T00:00:00Z

Several patient groups (e.g., intractable epilepsy, intracerebral tumours) require neurosurgical treatment. The goals of neurosurgery are to resect affected tissue, and to avoid morbidity of function. Previous studies have validated the ability of single fMRI tasks for the preoperative investigation of the localization and lateralization of functions such as language, memory and motor functioning, with a notable paucity of fMRI studies conducted in children. The limitations of using single-tasks for preoperative evaluations have been identified, including discrepancies with ‘gold-standard’ techniques such as the Wada Test and Cortical Stimulation Mapping in terms of lateralization of functions, particularly for language. However, few studies have attempted to use a battery of tasks to combat these issues. Of the few existing studies employing fMRI task batteries, most have been conducted in adults, and have tended to focus on language functions. The current study developed and evaluated the use of a brief fMRI task battery for neurofunctional investigation of language, memory encoding and motor functioning in a sample of 22 healthy children (aged 6.4-16.6 years); that can be used with children of various ages and abilities, and thus it is envisaged that the task battery can be applied to clinical paediatric populations for the purposes of preoperative localization and lateralization of these functions. The study employed two tasks well-reported in existing adult and paediatric fMRI literature (noun-verb generation, NVG; and finger opposition, FO), and two ‘novel’ tasks for use in children (an auditory word presentation task of parametric design, WA; and a picture encoding task, PE). As hypothesized, the tasks showed robust activation in the predicted regions (inferior and middle frontal regions for NVG; M1, S1, SMA and cerebellum for the FO task; superior temporal gyrus and primary auditory association cortex for the WA task; and anterior medial temporal lobe for the PE task). Lateralization indices were also conducted for the NVG, WA and PE tasks. The limitations and considerations of use of fMRI in clinical paediatric populations are also discussed, including the use of mock scanners with paediatric fMRI studies, and the lack of a paediatric atlas equivalent to existing adult atlases for analysis of fMRI data. This study concludes that the proposed fMRI battery provides a brief, valid means for neurofunctional investigation of language, memory encoding and motor functioning in healthy children; which has potential for use in preoperative investigation of these functions in children with neuropathology, in conjunction with other assessment methods such as the Wada Test, Cortical Stimulation Mapping, and neuropsychological assessment.

The Effect of Threat Source Proximity and Anxiety on the Attentional and Emotional Processing of Fear-Relevant Threat

Ms Shu-yang Chen — 2011-11-11T00:00:00Z

The project was designed to explore the effects of threat proximity and anxiety on the attentional and emotional processing of fear-relevant threat. Several well-established cognitive experimental tasks (e.g., affective priming and dot-probe paradigms) were employed across two studies to assess attentional processing to threat. Threat proximity was varied through the presence or absence of a dead spider. The purposes of the pilot study were to establish attentional bias to phylogenetically fear relevant stimuli, to explore the effect of anxiety on attentional bias to these stimuli, and to investigate the existence of automatic processing towards these stimuli. No priming effect was found in the affective priming paradigm, yet attentional biases to nonmasked fear relevant threats were observed in the dot-probe paradigm. The main goal of the main experiment was to explore the effect of threat source proximity on attentional bias to threat. Clear priming effects were observed, yet attentional biases were only observed for snakes and sad facial expressions when they were consciously processed. The priming effect of spiders was related to fear of spiders. Attentional biases, however, were not related to any of the fear measures. Being in different groups (i.e., spider present vs. spider absent) did not influence the priming effects, yet it exerted some influence on attentional processing in the dot-probe task. Specifically, attentional biases that were observed for snake stimuli when the probe appeared on the right in the spider absent group, were abolished in the spider present group. Unexpectedly, none of the psychophysiology measures were modulated by the valence of the stimuli. In general, no attentional bias was found for the masked stimuli. An interesting trend was observed where spider fearful individuals showed more bias towards snake stimuli, whereas snake fearful individuals showed more bias towards spider stimuli. Future research may choose to further explore the specificity of fear by employing more fear specific measures. In addition, a more controlled design with awareness checks for the masking procedure may be adopted in the future to examine automaticity. Future research may also examine the effects of and interaction between individual coping style and anxiety on attentional processing. Although the current research was not designed to investigate how experimental work in the area of cognitive processing can be used in clinical practice, the findings of the current study may be used to inform the development of therapeutic interventions in the near future.

The Effects of Alcohol-Related Television Advertising and Individual Differences in Personality on Alcohol Expectancies and Immediate Urge to Drink

Jeanette Van Luyn — 2012-09-25T00:00:00Z

The current study examined the effect of viewing different types of alcohol-related television advertising on immediate urge to drink and alcohol-related cognitions. The study aimed to integrate the role of individual differences in personality, as conceptualised in Gray’s Reinforcement Sensitivity Theory (RST), into the findings. 100 university students aged 18 to 32 years (Mage = 22.59 years) viewed a television segment embedded with either commercial alcohol advertisements, government endorsed anti-binge-drinking advertisements, or non-alcohol related neutral advertisements. Participants then completed a computerised implicit measure of alcohol expectancies (the ETask) that was embedded with either alcohol or non-alcohol beverage cues. Participants also completed self-report measures of the original and revised RST, explicit alcohol expectancies, immediate affective state, and current drinking behaviour. Subjective, immediate urge to drink was measured at baseline and after viewing the television segment and completing the ETask. The results revealed that while viewing commercial alcohol advertisements appeared to increase immediate desire to drink, they did not affect implicit or explicit endorsement of alcohol expectancies. Additionally, there was some evidence that government anti-binge drinking advertisements also increased immediate desire to drink, while not affecting implicit or explicit endorsement of alcohol expectancies. Finally, it was found that individual differences in sensitivity to reward had selective effects on reactivity to the alcohol-related advertisements, including ratings of urge to drink for emotion-regulation motives. This study contributes to current knowledge as to how alcohol-related advertising may affect drinking behavior on an individual, as well as population, level basis.

The Effects of Neuropsychological Assessment Feedback on Older Adults and Their Carers

Natasha S. Squelch — 2009-11-17T00:00:00Z

Neuropsychological assessment feedback (NAF) has received very limited attention in the literature (Allen et al., 1986; Gass & Brown, 1992; Gorske & Smith, 2008; Pope, 1992). This is surprising given the importance that has been placed on the provision of feedback in clinical practice (e.g., Gass & Brown, 1992; Smith, Wiggins, & Gorske, 2007). Approaches to NAF delivery, and the effects of feedback on clients and their families, remain relatively unexplored across age groups. In particular, to date no study has examined the effects of NAF on older adults and their carers presenting for investigation of dementia. Further, no study has examined or directly compared the effects of different NAF approaches in the older population. To fill this void in the literature, the primary aim of the current study was to examine the effects of two different approaches to neuropsychological assessment and feedback, namely Information Gathering (IG) and Collaborative Neuropsychological Assessment (CNA) on older adults referred for dementia investigations and their carers. Outcome variables included: patient and carer depression, anxiety, and service satisfaction; patient insight; and carer burden. Study 1 investigated the effects of IG and CNA approaches to neuropsychological assessment and feedback on 44 patients aged 60-89 years (M = 72.55) referred for dementia investigation by specialist practitioners at the Geriatric and Rehabilitation Unit, Princess Alexandra Hospital, Brisbane, Australia. Participants were systematically allocated to an IG group or a CNA group. All patients attended a neuropsychological assessment interview session, testing session, and feedback session. Outcome variables included the following self-report instruments: the Geriatric Depression Scale – 30 item (GDS-30; Brink et al., 1982); the Geriatric Anxiety Inventory (GAI; Pachana, Byrne, Siddle, Koloski, Harley, & Arnold, 2007); the Deficit Awareness Questionnaire (DAQ; Green, Goldstein, Sirockman, & Green, 1993); the Pre-Feedback Questionnaire and the Post-Feedback Questionnaire (Pre-FQ; Post-FQ respectively); and the Neuropsychological Assessment Objective Questionnaire (NAOQ; completed by the CNA group only). In addition, outcome variables included the clinician-rated Impaired Self-Awareness scale (ISA; Prigatano & Klonoff, 1998) and the Denial of Disability scale (DD; Prigatano & Klonoff, 1998). Nonparametric analyses were conducted due to low participant numbers and violations of statistical assumptions. Results indicated significant time effects amongst the CNA group on depression levels as measured by the GDS-30 (c2 = 6.911, df = 2, p < .05) and on overall self-awareness as measured by the DAQ total discrepancy score (c2 = 8.970, df = 2, p < .05). No significant time effects amongst the IG group, and the CNA group, were indicated on anxiety levels as measured by the GAI. Significant time effects were demonstrated amongst the IG group, and the CNA group, on overall feedback satisfaction as measured by the Pre-FQ and the Post-FQ total scores (IG: z = -3.128, N-Ties = 3, p = .002, two-tailed; CNA: z = -3.426, N-Ties = 7, p = .001, two-tailed). Significant time effects were indicated amongst the IG group on four of the eight individual questions comprising the Pre-FQ and the Post-FQ, and amongst the CNA group on seven of the eight individual questions comprising the Pre-FQ and the Post-FQ. The majority of patients in the IG group, and the CNA group, were very satisfied or satisfied with aspects of the neuropsychological assessment feedback session and overall neuropsychological assessment process, as measured by the individual questions comprising the Post-FQ. Group comparisons revealed no significant main effect for time, and no significant main effect comparing the two approaches on any of the outcome measures, with the exception of a main effect for time on two of the eight individual questions comprising the Pre-FQ and the Post-FQ. Study 2 examined the effects of IG and CNA approaches to neuropsychological assessment and feedback on 44 carers of the patients recruited for Study 1. Carers were aged 60-89 years (M = 69.80) and in conjunction with the patient were allocated to an IG group or a CNA group. All carers participated in the patient neuropsychological assessment interview session and feedback session. Outcome variables included the following self-report measures: the Geriatric Depression Scale – 15 item (GDS-15; Sheikh & Yesavage, 1986); the GAI (Pachana et al., 2007); the DAQ (Green et al., 1993); the Revised Memory and Behaviour Problems Checklist (RMBPC; Teri et al., 1992); the Pre-FQ; the Post-FQ; and the NAOQ (completed by the CNA group only). Due to low participant numbers and violations of statistical assumptions, nonparametric analyses were performed. Results indicated significant time effects amongst the IG group on overall burden as measured by the RMBPC Reaction total score (c2 = 7.588, df = 2, p < .05). No significant time effects amongst the IG group, and the CNA group, were indicated on depression levels as measured by the GDS-15, or on anxiety levels as measured by the GAI. Results indicated significant time effects amongst the IG group, and the CNA group, on overall feedback satisfaction as measured by the Pre-FQ and the Post-FQ total scores (IG: z = -3.833, N-Ties = 3, p = .000, two-tailed; CNA: z = -3.626, N-Ties = 2, p = .000, two-tailed) and on all of the eight individual questions comprising the Pre-FQ and the Post-FQ. The majority of carers in the IG group, and the CNA group, were very satisfied or satisfied with aspects of the neuropsychological assessment feedback session and overall neuropsychological assessment process, as measured by the individual questions comprising the Post-FQ. Group comparisons revealed no significant main effect for time, and no significant main effect comparing the two approaches on any of the outcome measures, with the exception of a large main effect for time on overall feedback satisfaction as measured by the Pre-FQ and the Post-FQ total scores, Wilks Lambda = .67, F (1, 41) = 20.18, p < .05, partial eta squared = .330, and on four of the eight individual questions comprising the Pre-FQ and the Post-FQ. The results for Study 1 and 2 are discussed in relation to existing literature. The clinical implications of these findings are considered, followed by a discussion of study limitations and suggestions for future research.

The Experiences of Students with Mental Health Conditions in Higher Education

Ms Eva-Marie Seeto — 2010-11-24T00:00:00Z

Over the past decade, both Australian and international literature has indicated that the number of students in higher education reporting mental health problems and complex support needs has been steadily increasing. Universities are supportive of these students and are able to address the many challenging aspects of academic requirements that may exacerbate the health concerns of students with serious mental health conditions through the provision of academic accommodations and inclusive structural systems at an institutional level. Under the Disability Standards for Education (2005), Disability Discrimination Act (1992), students are entitled to receive academic accommodations that counterbalance any functional disadvantage they may experience as the result of a disability. Flexibility in the learning environment provides greater inclusiveness for the whole student community. The potential pressures of exam environments, the stress of concurrent assignments, or difficulties encountered through interpersonal interactions, may be addressed through variations to assessment. It is only through gaining greater understanding of the direct experiences of students with mental health problems, however, that universities will be able to refine enabling strategies and develop essential supports that will allow students to participate fully in academic life and achieve their educational goals. Through the use of grounded theory methodology, this research investigated the experiences of twelve students with mental health conditions who were undertaking higher education on the Sunshine Coast in South-East Queensland. The project explored students’ lived experience of having mental health difficulties and the impact on their academic performance. It included the perceived level of support that students received, the quality of communication with education staff, and identified areas of unmet need. Overall, results reflected previously documented findings regarding the academic and social experiences of students with psychological disorders. While the barriers of perceived stigma and doubt could impede access to services for some students, participants generally described positive practical and emotional supports provided by the institution, and the challenges associated with managing the unpredictable nature of their mental health. The most significant finding identified from this research, was unmet need around peer support. Access to a peer mentoring or online support program specifically for students with mental health conditions was discussed by all participants. They strongly expressed a belief that the sharing of study skills, coping techniques and social engagement with peers would improve their understanding of, and functioning in, the academic environment. Further research into the practical considerations around peer provided pastoral support would enable development and assessment of future mentoring strategies and mentor training programs.

The familial transmission of anxiety: a test of the cognitive model

Ms Yen Fern Chaw — 2009-07-13T00:00:00Z

Studies in the existing literature have consistently demonstrated the aggregation of anxiety in families, and suggested that cognitive factors are important in the etiology and maintenance of anxiety. However, few studies have investigated the role of cognitive factors/mechanisms in the familial transmission of anxiety. Limited research on the cognitive measures and models of anxiety has also been conducted in the Asian context. This thesis seeks to address the existing gaps in the literature by investigating the role of cognitive factors in the psychopathology and familial transmission of anxiety in a Singapore/Asian sample. Chapter one provides a review of the literature on the familial aggregation of anxiety and research that has evaluated the contributions of genetics, environmental factors (with a particular focus on parenting factors), and cognitive factors in the transmission of anxiety from parents to offsprings. Chapters two, three and four comprised of studies that examined the psychometric properties of three anxiety cognitive measures (i.e. Anxiety Control Questionnaire (ACQ), Anxious Self-Statements Questionnaire (ASSQ), and Anxiety Attitude and Belief Scale (AABS)) in the Singapore/Asian context. Exploratory factor analyses and confirmatory factor analyses conducted with the ACQ and ASSQ demonstrated revised factor structures of the two measures, which were thus named as the ACQ-A and ASSQ-A. The ACQ-A comprised of two factors, namely Threat Control and Emotion Control, while the ASSQ-A comprised of three factors, namely Self-Doubt, Inability to Maintain Coping, and Negative Thinking/Worry. As for the AABS, exploratory factor analysis also showed a revised three-factor solution comprising of Catastrophising, Vigilance/Avoidance, and Reasonable Anxiety-Related Beliefs. The three validation studies also found satisfactory internal consistency for all the total scales and the factor scales of the three measures. Concurrent and discriminant validities of all three scales were also demonstrated, hence suggesting that the ACQ-A, ASSQ-A and the AABS-A were valid and reliable instruments for assessing anxiety control, anxious self-statements and anxiety attitudes/beliefs amongst Asian, in particular Singapore, community samples. Chapter five comprised of a study aimed to test the cognitive model of anxiety in the Singapore/Asian context. Five models that investigated the possible influence of anxiety cognitions (i.e. danger-relevant beliefs, anxiety control and anxious self-statements) on anxiety symptoms were tested. Structural equation modeling revealed that danger-relevant beliefs and anxiety control, when considered separately, have indirect influences on anxiety symptoms through anxious self-statements serving as a cognitive mediator. The model which provided the best fit involved a composite construct of anxiety beliefs comprising of both danger-relevant beliefs and anxiety control, which influenced anxiety symptoms directly, as well as indirectly via anxious self-statements. The results supported existing cognitive theories of anxiety, and thus hold implications for the prevention and treatment of anxiety problems among adults in the Asian context. Chapter six investigated the cognitive mechanism of familial transmission of anxiety in a community sample of adult offsprings and one of their parents. Structural equation modeling (SEM) was used to compare six transmission models of anxiety cognitions and symptoms from parents to offsprings. Results revealed that parent danger-relevant beliefs had a significant influence on offspring danger-relevant beliefs, while parent anxious self-statements also had a significant influence on offspring anxious self-statements. However, there were no significant influences of parent anxiety control on offspring anxiety control, and parent anxiety symptoms on offspring anxiety symptoms. The model, which provided the best fit involved anxiety transmission via anxious self-statements, as well as a composite construct of anxiety beliefs comprising of both danger-relevant beliefs and anxiety control. The results supported the cognitive mechanism of anxiety transmission from parents to offsprings, and thus hold implications for the prevention and treatment of anxiety problems in the Asian context. The final chapter sought to consolidate the findings of all the studies conducted. Theoretical and clinical implications, as well as limitations and directions for future research were also discussed.

The Influence of Mood, Food Cues and Individual Differences in Eating Style, Personality and Hedonic Hunger on Eating Expectancies and Responses

Ameerah Binte Po'ad Mattar — 2011-12-09T00:00:00Z

The current study examined the effects of mood states, food cue exposure, and individual differences in eating styles, personality and hedonic hunger on implicit eating expectancies and eating-related responses, including the desire to eat and actual food intake. 109 female participants were shown either negative or neutral mood-inducing video clips. This was followed by exposure to either palatable or neutral food images, as well as an implicit measure of eating expectancies. Participants also completed self-report measures of eating styles, both the original and revised Reinforcement Sensitivity Theory (RST), and appetitive drive to consume palatable foods. Desire to eat was measured at three time points (baseline, following the mood manipulation procedure, and following the food cue exposure/implicit eating expectancies measure), while actual food intake was recorded at the final stage of the study. Results revealed that the desire to eat increased following exposure to palatable, but not neutral food cues. The effect of food cue exposure was strongest among participants with an external eating style and those high in hedonic hunger. Reward sensitivity and hedonic hunger were associated with implicit eating expectancies. Eating expectancies also mediated the relationships between reward sensitivity and emotional/external/disinhibited eating. Finally, only the revised Behavioural Inhibition System (r-BIS) was related to food intake, with higher r-BIS scores predicting less food consumption. There was limited support for the influence of negative mood on the desire to eat. These findings highlight the roles of eating styles, reward sensitivity, hedonic hunger and beliefs about eating in contributing to dysfunctional eating. Implications of the study are discussed.

The Prevention of Childhood Anxiety in Socioeconomically Disadvantaged Communities: A Universal School-Based Trial

Jayne Stopa — 2010-10-26T00:00:00Z

Anxiety disorders are among the most prevalent psychiatric disorders in children and adolescents, with up to 25% of children experiencing clinical anxiety at some point (Boyd, Kostanski, Gullone, Ollendick, & Shek, 2000; Essau, Conradt, & Petermann, 2000; Neil & Christensen, 2009; Tomb & Hunter, 2004). The impact of childhood anxiety is far-reaching, resulting in compromised functioning across a range of psychosocial domains, and typically persisting well into adolescence and adulthood (Pine, 1997). This issue is compounded by the fact that the majority of children with anxiety disorders do not receive the treatment they require (Esser, Schmidt, & Woemer, 1990; Hirschfeld et al., 1997; Olfson, Gameroff, Marcus, & Waslick, 2003; Sawyer, Kosky, Graetz, Arney, Zubrick, & Baghurst, 2000). Consequently, research efforts have prioritised the evaluation of universal interventions for anxiety delivered within the school system, providing a more cost-effective model of intervention. Research to date has been promising, indicating that universal school-based prevention of anxiety is effective in reducing internalising symptoms in children and adolescents (Neil & Christensen, 2009). The issue of childhood anxiety is magnified in areas of socioeconomic disadvantage, with children from these populations at an increased risk of developing anxiety disorders and other psychiatric disorders (Kessler et al., 1994; Miech, Caspi, Moffitt, Entner Wright, & Silva, 1999; Xue, Leventhal, Brooks-Gunn, & Earls, 2005). Children from disadvantaged communities less likely to receive psychological assistance (Cunningham & Frieman, 1996; Kazdin & Mazurick, 1994; Kazdin & Wassell, 1999; Misfud & Rapee, 2005), and face significant barriers to accessing the treatment they require (Owens et al., 2002). Despite the greater risk of anxiety faced by children living within socioeconomically disadvantaged communities, there is a paucity of research investigating the prevention of childhood anxiety disorders specifically within disadvantaged populations. The primary objective of this thesis was to evaluate the effectiveness of a well-validated cognitive-behavioural intervention for childhood anxiety, the FRIENDS for Life program, when delivered as a universal school-based intervention within a socioeconomically disadvantaged region. The study involved a cohort of 963 children from Grades 5, 6, and 7, who were enrolled at one of three primary schools within this region. Children from all schools participated in a teacher-led, manualised 12-session intervention for anxiety, delivered during regular classroom time within one regular school term. All participants completed a package of self-report measures assessing levels of anxiety and depressive symptomatology, as well as self-esteem, coping skills, and psychosocial difficulties, prior to commencing the intervention. These measures were readministered at the completion of the intervention, and again at 12 months post-intervention to participants in Grades 6 and 7 (children from Grades 5 and 6 during the intervention year) only. Results indicated significant reductions in anxiety and depressive symptomatology from pre to post-intervention, with these gains maintained at 12 months follow-up. Peer problems and conduct problems were significantly lower both at post-intervention and again at 12-months follow-up. Use of cognitive avoidance and behavioural avoidance strategies also significantly decreased, whilst self-esteem and cognitive behavioural problem-solving increased significantly over time. The findings further validate the FRIENDS for Life program, and demonstrate it’s effectiveness as a universal school-based intervention for children within socioeconomically disadvantaged populations. Clinical implications of these results are discussed, along with limitations and directions for future research.

The Protective Role of Hope in Individuals with Multiple Sclerosis and their Caregivers

Sindia Madan — 2013-02-16T12:11:35Z

Hope is defined as an enduring disposition relating to an individual's perceived capability to initiate and sustain movement towards goals (agency) and to develop workable routes to achieve them (pathways; Snyder, 2000). Despite a growing interest in this construct within the chronic illness literature, it has been neglected in research on individuals with MS and in the caregiving literature more broadly. This research represented the first examination of the stress-buffering effects of global hope and its components (agency and pathways) on adjustment to MS (Study 1) and the MS caregiving role (Study 2). Focal predictors across both studies were stress, hope, agency and pathways and the adjustment outcomes (criterion variables) of anxiety, depression, positive affect, positive states of mind and life satisfaction. It was hypothesised in both studies that greater levels of dispositional hope would be associated with changes in better psychological adjustment (lower anxiety and depression and higher positive affect, positive states of mind and life satisfaction), over 12 months, after controlling for the effects of relevant covariates. Secondly, it was predicted that hope would buffer the adverse effects of stress on psychological adjustment. That is, under conditions of high stress it was predicted that individuals with high levels of hope would report better adjustment than individuals with low levels of hope. In contrast, it was expected that under conditions of low stress, those reporting high or low hope would not differ in adjustment. Study 1 examined the direct and stress-buffering effects of global hope and its components on changes in adjustment to MS over 12 months. A total of 296 individuals with MS completed questionnaires at Time 1 and 12 months later, Time 2. Results of regression analyses showed that as predicted, greater hope was associated with better adjustment (higher satisfaction with life, positive states of mind and positive affect and lower depression) after controlling for the effects of relevant demographic (age and marital status) and illness variables (course, number of symptoms, cognitive impairment and disability). However, no main effects of hope on anxiety were found. Further, these direct effects of global hope were subsumed by stress-buffering effects. Specifically, under conditions of high stress, MS participants with high levels of hope experienced more positive states of mind and positive affect, and less anxiety and depression, than their low hope counterparts. In contrast, under conditions of low stress, those reporting high or low hope did not differ in adjustment. Regarding the hope components, the beneficial impacts of agency thinking emerged via a direct effects mechanism. That is, greater agency thinking predicted increased satisfaction with life, positive states of mind and positive affect, and lower levels of depression. In contrast, the effect of pathways thinking was evidenced via a stress-buffering mechanism. Specifically, pathways attenuated relations between stress and adjustment outcomes of positive states of mind, anxiety and depression. Overall, these findings underscore hope as an important coping resource for adjusting to MS, and accentuate the roles of both agency and pathways thinking and their different modes of influence in this process. Study 2 examined the direct and stress-buffering effects of global hope and its components on changes in adjustment to caregiving in MS over 12 months. A total of 140 caregivers and their care-recipients completed questionnaires at time 1 and 12 months later, Time 2. As predicted, results of regression analyses revealed that greater hope was associated with better adjustment (higher positive affect and positive states of mind and lower depression) after controlling for the effects of relevant caregiving context variables (caregiving prevents outside employment) and care recipient illness variables (number of symptoms, cognitive impairment and disability). However, no direct effects of hope on life satisfaction or anxiety emerged. Further, no stress-buffering effects of hope emerged. Regarding the hope components, only the agency dimension emerged as a significant predictor of adjustment. Specifically, greater levels of agency were associated with increased positive affect and positive states of mind. In general, these findings highlight hope as an important protective resource for coping with MS caregiving, and emphasise the role of agency thinking in this process. It was concluded, after taking findings of both studies into consideration, that both an individual's perception of being able to attain goals (agency), and their knowledge of potential routes to meet these goals (pathways), contribute towards improved psychological adjustment in individuals with MS and their caregivers. Potential avenues for future research and clinical practice implications are presented.

The Relationship Between Qua Bao and Gambling Behaviour: A Cross-Cultural Study of Vietnamese, Chinese and Anglo/Euro-Australians in Australia.

Mr Toan Nguyen — 2011-06-22T00:00:00Z

Culture has been identified as an important variable in relation to gambling behaviour however, there has been a considerable lack of empirical research in this area. In order to close the significant gap between culture and problem gambling behaviour, the present paper examined the relationship between Qua Bao (retribution), belief in good luck, psychological states, gambling cognitions, acculturation and gambling behaviour in Vietnamese, Chinese and Anglo/Euro-Australians living in Australia. In study 1, it was hypothesized that there will be a positive relationship between gambling affiliates and problem gambling in all cultural groups such that higher belief in good luck, psychological states, irrational gambling beliefs and Qua Bao will be associated with increased rates of gambling behaviour in the Vietnamese, Chinese and Anglo/Euro-Australian groups. In study 2, it was predicted that specific cultural beliefs such as Qua Bao in the Vietnamese group could better predict gambling behaviour compared to the Chinese and Anglo/Euro-Australian group. In study 3, it was predicted that acculturation could negatively predict gambling behaviour in the Vietnamese and Chinese group. Three hundred and seventy-eight participants completed self-report measures of gambling behaviour, gambling cognitions, psychological states, specific cultural beliefs and acculturation. The participants were recruited via the first year psychology student pool from the University of Queensland and individuals living in the metropolitan area in Brisbane. Results of study 1 showed that there was a positive relationship between gambling affiliates and problem gambling in all cultural groups. Results of study 2 showed that specific cultural beliefs such as Qua Bao in the Vietnamese group could better predict gambling behaviour compared to the Chinese and Anglo/Euro-Australian group. Results of study 3 showed that in addition to psychological states, gambling related cognitions, and acculturation, Qua Bao was also a significant predictor of gambling behaviour only for the Vietnamese community. The results support a cross-cultural model of understanding problem gambling behaviour. It would be of benefit to psychologists to consider specific cultural beliefs such as Qua Bao in their conceptualisation and treatment of patients with gambling problems, especially in the ‘at risk’ Vietnamese community, to ensure best clinical practice.

The role of depression and anxiety in obstructive sleep apnea syndrome

Jonathan G Andrews — 2008-11-27T00:00:00Z

Trial of an Intervention for adolescents with moderate to severe symptoms of depression using the beyondblue framework

Angelo Contarino — 2011-09-15T00:00:00Z

Abstract Objective: Adolescence is a period of development where rates of psychopathology increase significantly (Steiner & Feldman, 1996). Further, mental disorders such as depression have been named the major burden of disease amongst adolescent populations (Australian Institute of Health and Wellbeing [AIHW], 2007). There is a need to develop cost effective and accessible approaches to the prevention and early intervention of depression, including school-based programmes (Sawyer et al., 2000). Targeted interventions as opposed to universal prevention programmes appear to be generally offering more favourable short and long-term outcomes regarding the reduction of depressive symptoms (Sheffield et al., 2006). Based upon these research findings, the primary aims of this thesis were: 1. To take existing, theoretically driven processes used in the beyondblue Schools Research Initiative designed for students in grades 8 to 10, and to deliver them as a targeted intervention for students in grades 10 to 12 who had been screened for symptoms of depression; and 2. To conduct exploratory research into the impact of this targeted intervention on student symptomatology and general functioning before and after completion of the programme. Method: Forty-seven students aged between 14-17 years (M = 15.25 years, SD = 0.76) from a Catholic college north of Brisbane were recruited for this pilot study. As part of usual college processes all students in grades 10 to 12 were screened in order to determine the socio-emotional needs within the student population and to make an attempt to address these. Students who reported moderate to extremely severe scores on at least one of the Depression, Anxiety, and Stress Scale (DASS: Lovibond & Lovibond, 1995) subscales were then offered the opportunity to participate in this targeted programme, with the requirement of consent from students and their parents. Students for whom consent was not gained, were offered the options of attending internal individual counselling at the college or referrals to an external agency, such as a private counsellor/psychologist or the local Child and Youth Mental Health Service. Those who did consent to participate were divided into four groups with approximately equal numbers and then provided the same intervention sessions over an eight-week period. This division into four groups of approximately 12 students was decided upon for the optimum delivery of the programme, with no specific selection criteria used. Students were allocated to a group on receipt of their consent forms. Participants were assessed at pre intervention, post intervention, and follow-up using a number of self-report measures. Two N = 1 case studies were also included demonstrating improvement and mixed results respectively, exploring the possible factors associated with these individual outcomes. Results: The results demonstrated that adolescents experienced significant improvements in symptomatology (depression, anxiety, and anger), their general functioning (self-concept, positive thinking, and negative problem orientation), and the severity of their clinical status over time. Further, student involvement in the programme appears to have had a positive impact upon reported quality of life and help-seeking behaviours. Conclusion: The goal of this research was to explore the effectiveness of the beyondblue Schools Research Initiative materials when applied as part of a targeted intervention. Preliminary results are promising, although further work is required to enhance school-based interventions. Limitations, implications, and directions for future research are also addressed.

Type 2 diabetes and depression : an exploration into the most effective depression screen to be used in a type 2 diabetes population

Dann, Fiona — 2012-12-14T11:50:10Z

Understanding Children's Fear of Death

Ms Kerry Badenhorst — 2011-02-21T00:00:00Z

Abstract Work by Slaughter and Griffiths (2007) demonstrated that young children who had a mature death concept, that is, understanding death as a biological event occurring to all living things, had lower levels of death anxiety when age and general anxiety (via parent report) were controlled. The purpose of this study was to expand upon these findings with a more controlled correlational study, as well as a preliminary study investigating a death anxiety intervention for children. Study 1 investigated whether the developmental acquisition of mature concepts of death and human body function impacts upon children’s death anxiety when the effects of cognitive ability (IQ) and self reported general anxiety are controlled. Fifty children aged 6 to 8 years were individually interviewed about their understanding of death and body functioning, death anxiety, general anxiety, cognitive ability and life cycle experience. Bivariate correlational analyses revealed a significant negative correlation between body function knowledge and death anxiety. This relationship remained significant when controlling for IQ and general anxiety. Life cycle experience was also significantly negatively correlated to death anxiety with the relationship also remaining significant when IQ and general anxiety were controlled for. This finding provides further evidence that having mature human biological knowledge, specifically understanding the body in biological terms and functioning to maintain life, is associated with decreased death anxiety. Study 2 piloted a one session life cycle training package as an intervention to address children’s fear of death. Eight children were recruited from Study 1’s sample. Life cycle understanding, death anxiety and general anxiety were assessed prior to the training and then approximately one week post training administration. Repeated measures t-tests revealed a significant reduction in children’s death anxiety post training. Whilst children’s life cycle understanding scores increased following training administration, the changes did not reach statistical significance. General anxiety scores also remained unchanged at post training assessments. Clinical implications for these findings and limitations of the studies are discussed.

Using the Dysexecutive Questionnaire (DEX) to examine the role of executive functioning in anxiety and depression

Shaw, Simone — 2008-11-24T00:00:00Z