Dropout from internet-based treatment for psychological disorders

Purpose: The purpose of this review was to present an in-depth analysis of literature identifying the extent of dropout from Internet-based treatment programmes for psychological disorders, and literature exploring the variables associated with dropout from such programmes. ----- ----- Methods: A comprehensive literature search was conducted on PSYCHINFO and PUBMED with the keywords: dropouts, drop out, dropout, dropping out, attrition, premature termination, termination, non-compliance, treatment, intervention, and program, each in combination with the key words Internet and web. A total of 19 studies published between 1990 and April 2009 and focusing on dropout from Internet-based treatment programmes involving minimal therapist contact were identified and included in the review. ----- ----- Results: Dropout ranged from 2 to 83% and a weighted average of 31% of the participants dropped out of treatment. A range of variables have been examined for their association with dropout from Internet-based treatment programmes for psychological disorders. Despite the numerous variables explored, evidence on any specific variables that may make an individual more likely to drop out of Internet-based treatment is currently limited. ----- ----- Conclusions: This review highlights the need for more rigorous and theoretically guided research exploring the variables associated with dropping out of Internet-based treatment for psychological disorders.

The Australian Grey Nomads : are they who we think they are? Enhancing formative research through the quantitative assessment of psychological constructs

Issue addressed: Measures of 'social identity' and 'psychological sense of community' were included within a broader formative research inquiry to gain insight into the identity characteristics and level of connectedness among older recreational road travellers (commonly known as Grey Nomads). The research sought to gain insights on how best to reach or speak to this growing driver cohort. ----- ----- Method: Participants included 631 older recreational road travellers ranging in age from 50 years to over 80 years. Data were obtained through three scales which were incorporated into a larger formative research survey; an identity hierarchy, the Three Factor Model of Social Identity and the Sense of Community Index. ----- ----- Results: Older recreational road travellers see themselves principally as couples, with social group identity being secondary. Although many identified to some degree with the Grey Nomad identity, when asked to self categorise as either members of the Broad Network of Recreational Vehicle Travellers or as Grey Nomads, the majority categorised themselves as the former. Those identifying as Grey Nomads, however, reported significantly higher levels of 'social identification' and 'sense of community'. ----- ----- Conclusion: The Grey Nomad identity may not be the best identity at which to target road safety messages for this cohort. Targeting travelling 'couples' may be more efficacious. Using the 'Grey Nomad' identity is likely to reap at least some success, however, given that many identified to some degree with this group identity. Those identifying as Grey Nomads may be more open to community participation or behaviour change given their significantly higher levels of 'social identity' and 'sense of community'.

The mediating effects of the time structure on the relationships between time management behaviour, job satisfaction and psychological wellbeing

This article examined the relationship between time structure and Macan's process model of time management. This study proposed that time structure—‘appraisal of effective time usage’—would be a more parsimonious mediator than perceived control over time in the relationship between time management behaviours and outcome variables, such as job satisfaction and psychological well-being. Alternative structure models were compared using a sample of 111 university students. Model 1 tested Macan's process model of time management with perceived control over time as the mediator. Model 2 replaced perceived control over time by the construct of time structure. Model 3 examined the possibility of perceived control over time and time structure as being parallel mediators of the relationships between time management and outcomes. Results of this study showed that Model 1 and Model 2 fitted the data equally well. On the other hand, the mediated effects were small and partial in both models. This pattern of results calls for reassessment of the process model.

The psychological distress of the young driver : a brief report

Objective: To explore the role of psychological distress in the self-reported risky driving of young novice drivers. Design: Cross-sectional online survey of 761 tertiary students aged 17-25 years with an intermediate (Provisional) driving licence who completed Kessler’s Psychological Distress Scale and the Behaviour of Young Novice Drivers Scale. Setting: Queensland, Australia, August-October 2009. Main outcome measures: Psychological distress, risky driving. Results: Regression analyses revealed that psychological distress uniquely explained 8.5% of the variance in young novice’s risky driving, with adolescents experiencing psychological distress also reporting higher levels of risky driving. Psychological distress uniquely explained a significant 6.7% and 9.5% of variance in risky driving for males and females respectively. Conclusions: Medical practitioners treating adolescents who have been injured through risky behaviour need to aware of the potential contribution of psychological distress, whilst mental health professionals working with adolescents experiencing psychological distress need to be aware of this additional source of potential harm. The nature of the causal relationships linking psychological distress and risky driving behaviour are not yet fully understood, indicating a need for further research so that strategies such as screening can be investigated.

Youth theatre and the articulation of cultural capital : refocusing Bourdieu through ethnography

This study of working-class and middle-class youth theatre workshops examines the processes through which this cultural form is appropriated by different class groups. Whereas the middle-class workshop proceeded efficiently and harmoniously, the working-class group resisted a number of institutional constraints traditionally associated with play rehearsal and performance. The processes of such symbolic struggle in the working-class group appeared to differ from Bourdieu's account of cultural domination. The article explores the explanatory contribution of the ethnographic case study to the analysis of the class basis of cultural tastes and practices and suggest that Bourdieu's account of class relations would gain from inclusion of this level of analysis. The situated study of the youth theatre workshops suggests that at this level, there is possibly more scope for symbolic struggle between the classes than was found by Bourdieu.

Online we are all able bodied : Online psychological sense of community and social support found through membership of disability-specific websites promotes well-being for people living with a physical disability

People with a physical disability are a population who for a number of reasons may be vulnerable to social isolation. Research into Internet-based support sites has found that social support and an online sense of community can be developed through computer mediated communication channels. This study aims to gain an understanding of the benefits that membership of disability-specific online communities may have for people with a physical disability. An online survey was administered to a sample of users of such sites (N = 160). Results indicated that users did receive moral support and personal advice through participating in such online communities. Further, results indicated that online social support and feeling a sense of community online were positively associated with participants' well-being in the areas of personal relations and personal growth.

Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

Background Up to one-third of people affected by cancer experience ongoing psychological distress and would benefit from screening followed by an appropriate level of psychological intervention. This rarely occurs in routine clinical practice due to barriers such as lack of time and experience. This study investigated the feasibility of community-based telephone helpline operators screening callers affected by cancer for their level of distress using a brief screening tool (Distress Thermometer), and triaging to the appropriate level of care using a tiered model. Methods Consecutive cancer patients and carers who contacted the helpline from September-December 2006 (n = 341) were invited to participate. Routine screening and triage was conducted by helpline operators at this time. Additional socio-demographic and psychosocial adjustment data were collected by telephone interview by research staff following the initial call. Results The Distress Thermometer had good overall accuracy in detecting general psychosocial morbidity (Hospital Anxiety and Depression Scale cut-off score ≥ 15) for cancer patients (AUC = 0.73) and carers (AUC = 0.70). We found 73% of participants met the Distress Thermometer cut-off for distress caseness according to the Hospital Anxiety and Depression Scale (a score ≥ 4), and optimal sensitivity (83%, 77%) and specificity (51%, 48%) were obtained with cut-offs of ≥ 4 and ≥ 6 in the patient and carer groups respectively. Distress was significantly associated with the Hospital Anxiety and Depression Scale scores (total, as well as anxiety and depression subscales) and level of care in cancer patients, as well as with the Hospital Anxiety and Depression Scale anxiety subscale for carers. There was a trend for more highly distressed callers to be triaged to more intensive care, with patients with distress scores ≥ 4 more likely to receive extended or specialist care. Conclusions Our data suggest that it was feasible for community-based cancer helpline operators to screen callers for distress using a brief screening tool, the Distress Thermometer, and to triage callers to an appropriate level of care using a tiered model. The Distress Thermometer is a rapid and non-invasive alternative to longer psychometric instruments, and may provide part of the solution in ensuring distressed patients and carers affected by cancer are identified and supported appropriately.

The psychological impact of industrial strikes: Does involvement in union activity during strikes make a difference?

The current study investigated the psychological impact of a United Steelworkers of America strike on the steelworkers involved, and the relationship between psychological well-being and individuals' levels of involvement in union activity during the strike. Three hundred and fifty-one steelworkers (302 `strikers' and 49 `non-strikers') completed surveys measuring a range of demographic and psychological well-being variables. Strikers, compared to non-strikers, reported higher levels of depression, anxiety, and irritation, and lower levels of mental health. For strikers, engaging in higher levels of union activity during the strike was associated with better psychological well-being. Jahoda's theory of deprivation during unemployment is used as the lens through which to explain some of the results, supporting the view that latent benefits associated with work are important for psychological well-being. A range of practical implications are offered for unions and their members.

Disclosure, conservatism and the cost of equity capital : a review of the foundation literature

In this review piece, we survey the literature on the cost of equity capital implications of corporate disclosure and conservative accounting policy choice decisions with the principle objective of providing insights into the design and methodological issues, which underlie the empirical investigations. We begin with a review of the analytical studies most typically cited in the empirical research as providing a theoretical foundation. We then turn to consider literature that offers insights into the selection of proxies for each of our points of interest, cost of equity capital, disclosure quality and accounting conservatism. As a final step, we review selected empirical studies to illustrate the relevant evidence found within the literature. Based on our review, we interpret the literature as providing the researcher with only limited direct guidance on the appropriate choice of measure for each of the constructs of interest. Further, we view the literature as raising questions about both the interpretation of empirical findings in the face of measurement concerns and the suitability of certain theoretical arguments to the research setting. Overall, perhaps the message which is most clear is that one of the most controversial and fundamental issues underlying the literature is the issue of the diversifiability or nondiversifiability of information effects.

Endogenous mortality, human capital and economic growth

We consider growth and welfare effects of lifetime-uncertainty in an economy with human capital-led endogenous growth. We argue that lifetime uncertainty reduces private incentives to invest in both physical and human capital. Using an overlapping generations framework with finite-lived households we analyze the relevance of government expenditure on health and education to counter such growth-reducing forces. We focus on three different models that differ with respect to the mode of financing of education: (i) both private and public spending, (ii) only public spending, and (iii) only private spending. Results show that models (i) and (iii) outperform model (ii) with respect to long-term growth rates of per capita income, welfare levels and other important macroeconomic indicators. Theoretical predictions of model rankings for these macroeconomic indicators are also supported by observed stylized facts.