To provide a review of the literature comparing anxious and depressive symptoms in caregivers of children with asthma with caregivers of healthy children.
A systematic search identified 25 studies ...from 17 articles, reporting outcomes on 4,300 caregivers of children with asthma and 25,064 caregivers of healthy children.
Overall, anxious (d = 0.50) and depressive symptoms (d = 0.44) were higher in caregivers of children with asthma compared with caregivers of healthy children. Age, site of recruitment, and whether the asthma diagnosis was medically confirmed were included as potential moderators. The relationship between parental psychopathology and asthma was stronger in those with medically confirmed asthma and participants recruited from clinical settings. Other moderators were not significant.
Caregivers of children with asthma appear to have greater anxious and depressive symptoms than caregivers of healthy children, but the reasons are unclear. More research that investigates modifiable factors that may moderate this association is urgently needed.
Objectives
Self-compassion is a healthy way of relating to one’s self motivated by a desire to help rather than harm. Novel self-compassion-based interventions have targeted diverse populations and ...outcomes. This meta-analysis identified randomized controlled trials of self-compassion interventions and measured their effects on psychosocial outcomes.
Methods
This meta-analysis included a systematic search of six databases and hand-searches of the included study’s reference lists. Twenty-seven randomized controlled trials that examined validated psychosocial measures for self-compassion-based interventions met inclusion criteria. Baseline, post and follow-up data was extracted for the intervention and control groups, and study quality was assessed using the PRISMA checklist.
Results
Self-compassion interventions led to a significant improvement across 11 diverse psychosocial outcomes compared with controls. Notably, the aggregate effect size Hedge’s
g
was large for measures of eating behavior (
g
= 1.76) and rumination (
g
= 1.37). Effects were moderate for self-compassion (
g
= 0.75), stress (
g
= 0.67), depression (
g
= 0.66), mindfulness (
g
= 0.62), self-criticism (
g
= 0.56), and anxiety (
g
= 0.57) outcomes. Further moderation analyses found that the improvements in depression symptoms continued to increase at follow-up, and self-compassion gains were maintained. Results differed across population type and were stronger for the group over individual delivery methods. Intervention type was too diverse to analyze specific categories, and publication bias may be present.
Conclusions
This review supports the efficacy of self-compassion-based interventions across a range of outcomes and diverse populations. Future research should consider the mechanisms of change.
Beck's theory suggests that forming negative self-cognitions is a key early step in the development of depression. However, others have suggested the reverse, arguing that depression leads to ...development of negative self-beliefs. As such, there is debate about whether these cognitions are precursors to, or alternatively are caused by, depression. Although Beck's theory is supported in older adolescents, it has not been clearly seen in younger adolescents. This study aimed to assess the relation between two major self-cognitions (self-esteem and self-criticism) and depressive symptoms in early adolescence. Two-hundred and forty-three Australian adolescents (mean age = 12.08, 52% female) completed measures of self-esteem, self-criticism and depressive symptoms at baseline, then approximately 12- and 24-months later. Growth-curve modelling was used to assess changes in the variables. Cross-lagged analysis assessed whether either of the self-cognition variables predicted depressive symptoms, or if depressive symptoms predicted self-cognitions. Results indicated that self-criticism and depressive symptoms increased over the time period, while self-esteem decreased, and these changes were all related. Self-esteem predicted depressive symptoms from Time 2 to Time 3, while depressive symptoms predicted self-esteem from Time 1 to Time 2. Self-criticism did not predict depressive symptoms, nor did depressive symptoms predict self-criticism. These links appeared largely independent of gender. Self-esteem and depressive symptoms during the early adolescent period thus appear to have a somewhat reciprocal relation, while self-criticism does not appear to predict the development of depression. As such, while low self-esteem does appear to have an important role of in the development of depression in this age group, it is not strictly predictive, nor is this effect seen across all negative self-cognitions.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Recent research suggests that the transdiagnostic construct of death anxiety may be a basic fear underlying a range of anxiety disorders. Although the investigation of death anxiety in clinical ...populations is relatively recent, the death anxiety literature as a whole has a longer history evidenced by the number of instruments developed to measure this construct. This systematic review aimed to evaluate the evidence supporting the psychometric properties of self-report death anxiety measures. Relevant studies were identified via a systematic search of four electronic databases in addition to reference list searches. Two independent reviewers evaluated relevant studies using the established Terwee et al. quality appraisal tool. Of the 1831 studies identified, 89 met inclusion criteria. These studies investigated the psychometric properties of 21 self-report scales of death anxiety as well as six subscales. No measure was found to possess evidence of adequacy on all evaluated quality criteria. The Templer Death Anxiety Scale, Concerns about Dying Instrument and Death Concern Scale were found to possess the most evidence supporting their validity and reliability. Overall findings suggest that additional research is needed to establish the psychometric adequacy of death anxiety instruments, especially given increased utilization of these measures in both clinical and research settings.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Abstract Purpose This study tested the efficacy of an intervention for anxious adolescent boys experiencing bullying at school. The cognitive–behavioral intervention focused on targeting individual ...factors that appear to increase an adolescent's vulnerability to bullying experiences such as anxiety, low self-esteem, and use of maladaptive coping strategies. Methods Adolescent boys reporting anxiety symptoms and the recent experience of being bullied at school (grades 7–10) were randomly assigned by group to intervention (n = 22) or wait-list (n = 24) conditions. Depressive and anxiety symptoms and bullying experiences were measured before and after the intervention, and at a 3-month follow-up for the intervention condition. Results The intervention was effective in significantly reducing adolescent's bullying experiences as well as their anxiety, depression, and the degree of distress associated with being bullied. Intervention gains were maintained at the 3-month follow-up. The intervention was not effective in enhancing adolescent's self-esteem or changing aggressive or avoidant responses to bullying situations. Conclusions This study provides preliminary support for the value of individually focused interventions for boys in the effort to reduce the incidence of bullying within schools.
Aim
To examine the effectiveness of discharge planning on length of stay and readmission rates among older adults in acute hospitals.
Background
Discharge planning takes place in all acute hospital ...settings in many forms. However, it is unclear how it contributes to reducing patient length of stay in hospital and readmission rates.
Methods
Seven systematic reviews were identified and examined. All of the systematic reviews explored the impact of discharge planning on length of stay and readmission rates.
Results
A limited meta‐analysis of the results in relation to length of stay indicates positive finding for discharge planning as an intervention (MD = −0.71(95% CI −1.05,−0.37; p = .0001)). However, further analysis of the broader findings in relation to length of stay indicates inconclusive or mixed results. In relation to readmission rates both meta‐analysis and narrative analysis point to a reduced risk for older people where discharge planning has taken place (RR = 0.78 (95% CI: 0.72, 0.84; p = .00001)). The ability to synthesize results however is severely hampered by the diversity of approaches to research in this area.
Implications for Nursing Management
It is unclear what impact discharge planning has on length of stay of older people. Indeed, while nurse mangers will be interested in gauging this impact on throughput and patient flow, it is questionable if length of stay is the correct outcome to measure when studying discharge planning as good discharge planning may increase length of stay. Readmission rates may be a more appropriate outcome measure but standardization of approach needs to be considered in this regard. This would assist nurse managers in assessing the impact of discharge planning processes.
Objective: To investigate the prevalence of comorbid eating and anxiety disorders in women presenting for inpatient and outpatient treatment of an eating disorder and women presenting for outpatient ...treatment of an anxiety disorder.
Methods: The prevalence of comorbidity was investigated from a sample of 152 women, which included 100 women presenting for treatment of an eating disorder and 52 women presenting for treatment of an anxiety disorder.
Results: Of women presenting for treatment of an eating disorder, 65% also met criteria for at least one comorbid anxiety disorder; 69% of these reported the onset of the anxiety disorder to precede the onset of the eating disorder. Of the anxiety disorders diagnosed, social phobia was most frequently diagnosed (42%) followed by post-traumatic stress disorder (26%), generalised anxiety disorder (23%), obsessive–compulsive disorder (5%), panic/agoraphobia (3%) and specific phobia (2%). We also found that 13.5% of women presenting for anxiety treatment also met criteria for a comorbid eating disorder. Furthermore, 71% (n = 5) reported the onset of the anxiety disorder to precede the onset of the eating disorder.
Discussion: The results of this study suggest that the prevalence of eating and anxiety disorder comorbidity is high. The present research should improve the clinical understanding of the comorbidity between eating disorders and anxiety disorders. In particular, it is anticipated that this research will have significant aetiological and therapeutic implications especially with regard to improving the clinical effectiveness of psychological treatments for eating disorders and highlighting the importance of screening for eating pathology in the clinical assessment of anxiety disorders.
Bullying is an ongoing problem in our schools with a significant psychological impact on young people. Despite evidence that school-based bullying is related to a range of individual, social and ...environmental factors, the majority of interventions are focused on a "whole of school" approach. Whole-school interventions have been shown to be successful in reducing rates of bullying, but it is argued that a focus on individual factors, specifically those that are amenable to change, will add to these "whole of school" effects. It is argued that interventions that target factors such as internalising symptoms, externalising behaviours, friendship quality and self-esteem will help children to build resilience against the bullying behaviours of their peers, and further reduce the incidence of bullying, when applied both at a preventative and treatment intervention level.
Objective: The Resourceful Adolescent Program (RAP) is a universal, school-based intervention that has been found to produce small to medium effects in the reduction of adolescent depressive ...symptoms. In the present study, we evaluated the effectiveness of a friendship-building skills program-the Peer Interpersonal Relatedness (PIR) program-in producing larger effects when used in conjunction with RAP. Method: A cluster-randomized controlled trial was used to assign whole classrooms of adolescent participants recruited from Sydney secondary schools to 1 of 3 conditions: (a) RAP-PIR, (b) RAP-placebo, or (c) assessment-only waiting-list control. Hierarchical linear modeling (HLM) was used to analyze the data. Results: Across the intervention period, RAP did not significantly reduce depressive symptoms relative to those students not receiving this intervention. RAP followed by PIR did significantly reduce depressive symptoms relative to those students not receiving PIR. Across the 12-month follow-up, the between-group reductions in depressive symptoms were no longer significant. At follow-up, participants in the RAP-PIR condition had achieved significant increases in their school-related life satisfaction and significant increases in social functioning with peers relative to their peers in the other conditions. Conclusion: The study provides preliminary support for the effectiveness of the PIR program in reducing depressive symptoms when used alongside RAP in the short term and in improving social adjustment and school-related life satisfaction in the longer term. Given the importance of social adjustment in adolescent mental well-being, the PIR program represents a potentially important addition to the prevention of depression in youth.
Despite high rates of mental health disorders among cancer patients, uptake of referral to psycho-oncology services remains low. This study aims to develop and seek clinician and patient feedback on ...a patient decision aid (PDA) for cancer patients making decisions about treatment for anxiety and/or depression.
Development was informed by the International Patient Decision Aid Standards and the Ottawa Decision Support Framework. Psycho-oncology professionals provided feedback on the clinical accuracy, acceptability, and usability of a prototype PDA. Cognitive interviews with 21 cancer patients/survivors assessed comprehensibility, acceptability, and usefulness. Interviews were thematically analysed using Framework Analysis.
Clinicians and patients strongly endorsed the PDA. Clinicians suggested minor amendments to improve clarity and increase engagement. Patient feedback focused on clarifying the purpose of the PDA and improving the clarity of the values clarification exercises (VCEs).
The PDA, the first of its kind for psycho-oncology, was acceptable to clinicians and patients. Valuable feedback was obtained for the revision of the PDA and VCEs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
PDF
