Objective:
This study evaluated the effectiveness of mindfulness-based cognitive therapy (MBCT) for individuals with a diagnosis of cancer.
Method:
Participants (
N
= 115) diagnosed with cancer, ...across site and stage, were randomly allocated to either the treatment or the wait-list condition. Treatment was conducted at 1 site, by a single therapist, and involved participation in 8 weekly 2-hr sessions that focused on mindfulness. Participants meditated for up to 1 hr daily and attended an additional full-day session during the course. Participants were assessed before treatment and 10 weeks later; this second assessment occurred immediately after completion of the program for the treatment condition. The treatment condition was also assessed at 3 months postintervention. All postinitial assessments were completed by assessors who were blind to treatment allocation.
Results:
There were large and significant improvements in mindfulness (effect size ES = 0.55), depression (ES = 0.83), anxiety (ES = 0.59), and distress (ES = 0.53) as well as a trend for quality of life (ES = 0.30) for MBCT participants compared to those who had not received the training. The wait-list group was assessed before and after receiving the intervention and demonstrated similar change.
Conclusions:
These improvements represent clinically meaningful change and provide evidence for the provision of MBCT within oncology settings.
Objective:
Current and accurate estimates of prevalence, correlates, comorbid concerns and treatment-seeking behaviours associated with disorders are essential for informing policy, clinical practice ...and research. The most recent snapshot of social anxiety disorder in Australia was published more than a decade ago, with significant changes to the accessibility of mental health treatment services and diagnostic measures occurring during this period. This paper aims to (i) update the understanding of social anxiety disorder, its associations and patterns of treatment-seeking behaviours in the Australian population, and (ii) explore the impact of revised diagnostic criteria detailed in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) on prevalence estimates.
Methods:
The National Survey of Mental Health and Wellbeing (NSMHWB) was conducted by the Australian Bureau of Statistics in 2007, collecting information from a nationally representative random sample of 8841 Australians aged 16–85 years. The presence of social anxiety disorder diagnostic criteria and related disorders were assessed over 12 months and lifetime periods using the World Mental Health Composite International Diagnostic Interview.
Results:
Profiles of social anxiety disorder were consistent with previous estimates, with higher prevalence in females and younger age groups. Of the 8.4% of Australians meeting criteria for social anxiety disorder at some point in their lifetime (12-month prevalence 4.2%), a majority also experienced comorbid mental health concerns (70%). The revised performance-only specifier included in the DSM-5 was applicable to only 0.3% of lifetime cases. Just over 20% of people reporting social anxiety disorder as their primary concern sought treatment, most commonly through general practitioners.
Conclusions:
Social anxiety disorder continues to be prevalent in the Australian population and highly related to other disorders, yet few people experiencing social anxiety disorder seek treatment
There is compelling evidence that depression is an independent risk factor for both the development of Coronary Heart Disease (CHD) and for worsening prognosis once CHD is established. Given the ...increasing awareness of the high prevalence of co-morbid depression in individuals with CHD, clinical psychologists are likely to become increasingly involved in the care of cardiac patients. It is imperative therefore, that they are aware of the complex relationship between depression and CHD and are familiar with the pharmacological and psychological interventions most likely to be effective in these patients. The following review explores the epidemiological evidence for the relationship between depression and CHD, examines the biological, behavioral and social mechanisms that may account for this relationship, and considers the findings of the psychological and pharmacological intervention trials seeking to improve outcomes for depressed cardiac patients. Collaboration across a range of disciplines is needed to establish a program of research and professional education and to develop clinical practice guidelines and pathways which support the implementation of best practice in the assessment and management of co-morbid depression in people with and at risk of CHD. Clinical psychologists are well-equipped to take a lead in this important endeavor.
Personal protective equipment (PPE) is critical to the safety of health professionals and vital to clinical practice. However, there is little known about the cognitive and emotional impact of PPE on ...health professionals' performance, comfort, and well-being.
A mixed-method, cross-sectional, observational study was adopted. An online survey consisting of 5-point Likert scale questions and free-text comments canvassed the opinions of patient-facing health professionals.
An overall negative impact of PPE on health professionals' ability to carry out work was found from 185 responses from medicine, nursing, and allied health disciplines, including increased fatigue, poor communication, and feeling uncomfortable.
There are significant negative impacts of PPE on health professionals' ability to carry out work, impairing communication, task efficiency, and comfort. Personal protective equipment is an essential infection control practice requiring further research, design, and testing to overcome challenges.
Rationale
Baclofen has been shown to effect fMRI alcohol cue reactivity in alcohol dependence, but potential varying effects related to baclofen dose levels have not been examined.
Objective
This ...study investigated whether baclofen attenuates craving and alcohol cue–elicited activation in alcohol-dependent treatment seekers, and the relationship between this response and clinical outcomes (Morley et al.
2018
; Morley et al.
2013
).
Methods
Participants included 30 alcohol-dependent individuals who had received daily baclofen 30 mg (
n
= 11), 75 mg (
n
= 8) or placebo (
n
= 11) for at least 2 weeks. Using functional magnetic resonance imaging (fMRI), we examined alcohol cue–elicited neural activation during a visual alcohol cue reactivity task 120 min following treatment administration, and alcohol cue reactivity and percentage of heavy drinking days (% HDD) associations were assessed.
Results
Both baclofen-treated groups reported fewer post-scan % HDD when compared to the placebo-treated group, but no subjective craving group differences were found. Increased alcohol cue–elicited activation was seen in placebo compared to the 75 mg/day baclofen participants in two clusters spanning prefrontal regions implicated in cue reactivity, chiefly frontal regions (i.e., frontal and precentral gyri, anterior cingulate cortex), but no observed alcohol cue reactivity differences between placebo and 30 mg/day baclofen groups. Post-scan % HDD was positively correlated with increased alcohol cue–elicited activation in a cluster encompassing the bilateral caudate nucleus and dorsal anterior cingulate cortex when comparing placebo versus 75 mg/day baclofen groups, and several clusters including prefrontal and mesolimbic regions when comparing placebo versus 30 mg/day baclofen groups.
Conclusions
Baclofen administration attenuates alcohol cue–elicited activation and reduced the association in baclofen-treated participants between increased activity in key drug cue reactivity regions and higher post-scan % HDD observed in placebo-treated participants, suggesting a dose-specific response effect that may lead to reduced heavy drinking in chronic alcohol-dependent individuals.
Trial registration
ClinicalTrials.gov
, NCT01711125,
https://clinicaltrials.gov/ct2/show
/NCT01711125
•The factor structure of the SCAS-P is not identical in groups of young people with anxiety and ASD.•The relationship between SCAS-P items and factors differs across anxious and ASD groups.•ASD ...impacted on three of the six factors and eleven of the thirty-eight items of the SCAS-P.•Results on the SCAS-P in children with ASD need to be interpreted with caution.
The present study assessed the utility of the Spence Children's Anxiety Scale - Parent Form (SCAS-P) across parents of children with (i) anxiety and (ii) Autism Spectrum Disorder (ASD).
Parents of children aged 7–18 years with anxiety or ASD completed the SCAS-P. Multiple indicator multiple cause (MIMIC) structural equation modelling was utilized to analyse the data.
Analysis revealed different factor structures between the Anxious and ASD groups and evidence for measurement variance across groups in some parts of the SCAS-P.
Results on the SCAS-P in children with ASD need to be interpreted with caution. Some SCAS-P items cannot be interpreted in the same way in an ASD population compared to neurotypical children with anxiety.
•Regarding child anxiety symptoms, there is differential responding by parents of children with and without ASD.•A child's SCAS-P scores cannot be interpreted in the same way in an ASD population ...compared to typically developing children with and without anxiety.•The presence of ASD may alter the expression of some anxiety symptoms.•A new parent measure, aligned with DSM-5 and with clearer behavioural items, was developed to assess anxiety in typically developing children and adolescents as well as children with ASD.•The new measure (MABS) also demonstrated that ASD impacted on parental responding at the subscale and item level.•For ASD samples, a testlet of invariant items needs to be further evaluated.
Objective: This study examined measurement variance for Autism Spectrum Disorder (ASD) in the Spence Children's Anxiety Scale - Parent Form (SCAS-P; Spence, 1999). In addition, we developed and evaluated a new parent report measure for anxiety (Macquarie Anxiety Behavioural Scale; MABS). Method: The sample consisted of 734 parents of children aged 3–19 years (i) who were seeking help for their child's anxiety, (ii) who had received a diagnosis of ASD, or (iii) from the community. Results: Evidence for measurement variance of the SCAS-P and MABS was found, revealing different factor structures between the ASD and non-ASD groups. MIMIC modelling showed that the scales performed significantly different across ASD and non-ASD groups. Differential item functioning on a number of the SCAS-P and MABS items was also found. Limitations: This study relied on parent report of symptoms and of community acquired diagnoses of ASD. Conclusion: The MABS is a new parent measure to assess anxiety in children and adolescents and the proposed factor structure produced a reasonably good fit for the data. Similar to the SCAS-P, ASD was found to impact on some of the MABS items indicating that ASD influences parental responding. Eighteen MABS items showed measurement invariance across the anxious and ASD groups and can be considered suitable items for the assessment of anxiety in ASD.
Introduction: Individuals with alcohol use disorder (AUD) have difficulties regulating alcohol consumption, despite adverse drinking-related consequences. This may be due to incapacity incorporating ...previous negative feedback from drinking, resulting in impaired decision-making. Methods: We assessed whether decision-making is impaired in participants with AUD related to severity of AUD, indexed by severe negative drinking consequences using the Drinkers Inventory of Consequences (DrInC) and reward and punishment sensitivity with the Behavioural Inhibition System Behavioural Activation System (BIS BAS) scales. 36 treatment-seeking alcohol-dependent participants completed the Iowa gambling task (IGT) with skin conductance responses (SCRs) measured continuously as an index of somatic autonomic arousal to evaluate impaired expectancy of negative outcomes. Results: Two-thirds of the sample showed behavioural impairment during the IGT, with greater AUD severity related to worse performance. BIS moderated IGT performance according to severity of AUD, with increased anticipatory SCRs for those with fewer reported DrInC severe consequences. Participants with more DrInC severe consequences showed IGT deficits and reduced SCRs regardless of BIS scores. BAS-Reward was associated with increased anticipatory SCRs to disadvantageous deck choices among those with lower AUD severity, while SCRs did not differ related to AUD severity for reward outcomes. Discussion: Effective decision-making in the IGT and adaptive somatic responses were moderated by punishment sensitivity contingent on severity of AUD in these drinkers, with impairments in expectancy to negative outcomes from risky choices, including reduced somatic responses, resulting in poor decision-making processes that may help explain impaired drinking and worse drinking-related consequences.
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