The association between habitual diet quality and the common mental disorders in community-dwelling adults : The Hordaland health study

Objective Recent evidence suggests a role for diet quality in the common mental disorders depression and anxiety. We aimed to investigate the association between diet quality, dietary patterns, and the common mental disorders in Norwegian adults.

Methods This cross-sectional study included 5731 population-based men and women aged 46 to 49 and 70 to 74 years. Habitual diet was assessed using a validated food frequency questionnaire, and mental health was measured using the Hospital Anxiety and Depression Scale.

Results After adjustments for variables including age, education, income, physical activity, smoking, and alcohol consumption, an a priori healthy diet quality score was inversely related to depression (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.59–0.84) and anxiety (OR = 0.77, 95% CI = 0.68–0.87) in women and to depression (OR = 0.83, 95% CI = 0.70–0.99) in men. Women scoring higher on a healthy dietary pattern were less likely to be depressed (OR = 0.68, 95% CI = 0.57–0.82) or anxious (OR = 0.87, 95% CI = 0.77–0.98), whereas men were more likely to be anxious (OR = 1.19, 95% CI = 1.03–1.38). A traditional Norwegian dietary pattern was also associated with reduced depression in women (OR = 0.77, 95% CI = 0.64–0.92) and anxiety in men (OR = 0.77, 95% CI = 0.61–0.96). A western-type diet was associated with increased anxiety in men (OR = 1.27, 95% CI = 1.14–1.42) and women (OR = 1.29, 95% CI = 1.17–1.43) before final adjustment for energy intake.

Conclusions In this study, those with better quality diets were less likely to be depressed, whereas a higher intake of processed and unhealthy foods was associated with increased anxiety.

Gender-common and -specific neuroanatomical basis of human anxiety-related personality traits

Exploration of the relationships between regional brain volume and anxiety-related personality traits is important for understanding preexisting vulnerability to depressive and anxiety disorders. However, previous studies on this topic have employed relatively limited sample sizes and/or image processing methodology, and they have not clarified possible gender differences. In the present study, 183 (male/female: 117/66) right-handed healthy individuals in the third and fourth decades of life underwent structural magnetic resonance imaging scans and Temperament and Character Inventory. Neuroanatomical correlates of individual differences in the score of harm avoidance (HA) were examined throughout the entire brain using voxel-based morphometry. We found that higher scores on HA were associated with smaller regional gray matter volume in the right hippocampus, which was common to both genders. In contrast, female-specific correlation was found between higher anxiety-related personality traits and smaller regional brain volume in the left anterior prefrontal cortex. The present findings suggest that smaller right hippocampal volume underlies the basis for higher anxiety-related traits common to both genders, whereas anterior prefrontal volume contributes only in females. The results may have implications for why susceptibility to stress-related disorders such as anxiety disorders and depression shows gender and/or individual differences.

Associations between confidence, persistence, and optimism : illuminating optimistic problem solving activity

As part of video-stimulated post-lesson student interview studies of problem solving activity, Williams (2005, 2011) found successful problem solvers were optimistic. This study interrogates data from three students from a broader study: the role of optimism in collaborative problem solving and how to build it. The research question that focuses this study is “What associations exist between confidence, persistence, and optimism?” The question is explored both theoretically and empirically for the purpose of increasing understanding of the nature of optimistic problem solving activity by linking it to more familiar constructs. Students were progressively selected to further the interrogatory process. It was found that confidence and persistence did not necessarily occur together, and when they did, activity associated with these two characteristics was not sufficient for optimistic problem solving activity to occur. Perseverance was also required.

Telephone delivered health coaching improves anxiety outcomes after myocardial infarction : the 'ProActive Heart' trial

Background: Recently, we found a telephone-delivered secondary prevention programme using health coaching (‘ProActive Heart’) to be effective in improving a range of key behavioural outcomes for myocardial infarction (MI) patients. What remains unclear, however, is the extent to which these treatment effects translate to important psychological outcomes such as depression and anxiety outcomes, an issue of clinical significance due to the substantial proportion of MI patients who experience depression and anxiety. The objective of the study was to investigate, as a secondary hypothesis of a larger trial, the effects of a telephone-delivered health coaching programme on depression and anxiety outcomes of MI patients.

Design: Two-arm, parallel-group, randomized, controlled design with six-months outcomes.

Methods: Patients admitted to one of two tertiary hospitals in Brisbane, Australia following MI were assessed for eligibility. Four hundred and thirty patients were recruited and randomly assigned to usual care or an intervention group comprising up to 10 telephone-delivered ‘health coaching’ sessions (ProActive Heart). Regression analysis compared Hospital Anxiety and Depression Scale scores of completing participants at six months (intervention: n = 141 versus usual care: n = 156).

Results: The intervention yielded reductions in anxiety at follow-up (mean difference = -0.7, 95% confidence interval=-1.4,-0.02) compared with usual care. A similar pattern was observed in mean depression scores but was not statistically significant.

Conclusions: The ProActive Heart programme effectively improves anxiety outcomes of patients following myocardial infarction. If combined with psychological-specific treatment, this programme could impact anxiety of greater intensity in a clinically meaningful way.

The relationship between attachment style, anxiety sensitivity and interpretive bias among adolescent nonclinical panickers

Elevated anxiety sensitivity and the tendency to catastrophically misinterpret ambiguous bodily sensations has been demonstrated in people who experience nonclinical levels of panic (Richards, Austin, & Alvarenga, 2001), and anxiety sensitivity has been shown to be associated with insecure attachment in adolescents and young adults (Weems, Berman, Silverman, and Saavedra, 2001). This study investigated the relationship between attachment style, anxiety sensitivity and catastrophic misinterpretation among 11 nonclinical panickers and 58 nonanxious controls aged 18 to 19 years. Participants completed the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), Anxiety Sensitivity Index (ASI) and an attachment questionnaire. The hypothesis that insecurely attached individuals would demonstrate greater catastrophic misinterpretation and higher anxiety sensitivity than securely attached individuals was not supported; however, nonclinical panickers gave more anxiety-related interpretations of ambiguous internal stimuli than nonanxious controls. Results do not support the notion that attachment style is related to anxiety sensitivity or catastrophic misinterpretation (regardless of panic experience). Results do, however, support the notion that anxiety-related misinterpretation of ambiguous somatic sensations precedes the onset of panic disorder.

Somatic symptoms, hypochondriasis and psychological distress: a study of somatisation in Australian general practice

Objective: To measure the prevalence of somatisation (multiple somatic symptoms and hypochondriasis) among Australian general practice attendees, its recognition by general practitioners, and its relationship with symptoms of depression and anxiety. Design, setting and participants: Self-reported questionnaires completed by 10 507 consecutive patients aged ≥18 years attending 340 GPs enrolled in a 6-hour national mental health program of continuing professional development who accepted invitations to participate; audit form completed by GPs for each patient during the period March 2004 to December 2006. Main outcome measures: Somatic symptom severity (measured with the 15-item Patient Health Questionnaire [PHQ-15]); hypochondriasis (measured with the Whiteley Index [Whiteley-7]; depression and anxiety (measured by the Kessler Psychological Distress scale [K10]); prevalence of “somatisers” (defined by medium to severe somatic symptom severity and hypochondriasis); GP recognition of somatisation (determined by their responses on audit forms to questions on whether patient’s complaints were most likely to have a physical or psychological explanation). Results: 18.5% of patients were classified as somatisers and 9.5% as probable cases of depression or anxiety. While 29.6% of somatisers had high anxiety or depression scores, 57.9% of people with anxiety or depression were also somatisers. Sex and age asserted significant but weak effects on psychometric scores. GPs identified somatic complaints as “mostly explained by a psychological disturbance” in 25.1% of somatisers. Conclusions: Somatisation is common in general practice, and more prevalent than depression or anxiety. While a minority of somatisers have significant anxiety and depression, most patients with depression and anxiety have a significant degree of somatisation. Recognition of depression and anxiety can be hindered by a somatic presentation and attribution. On the other hand, managing somatisation does not just involve recognising depression and anxiety, but also dealing with the health anxieties that underpin hypochondriasis.

Dissemination of therapist-assisted internet cognitive behaviour therapy : development and open pilot study of a workshop

There is considerable research suggesting that therapist-assisted Internet cognitive behaviour therapy (ICBT) is efficacious in the treatment of depression and anxiety. Given this research, there is a growing interest in training students in therapist-assisted ICBT in order to assist with the dissemination of this emerging modality into routine clinical practice. In this study, we developed, delivered, and evaluated a therapist-assisted ICBT workshop for clinical psychology graduate students (n = 20). The workshop provided both research evidence and practical information related to the delivery of therapist-assisted ICBT. The workshop also incorporated an experiential component with students working on and discussing responses to client e-mails. Before and after the workshop, we measured knowledge of therapist-assisted ICBT research and professional practice issues, as well as attitudes towards and confidence in delivering therapist-assisted ICBT. Statistically significant changes were observed in all areas. Eighty-five per cent of students are now offering therapist-assisted ICBT under supervision. We conclude by discussing future research directions related to disseminating therapist-assisted ICBT.

The impact of smoking in adolescence on early adult anxiety symptoms and the relationship between infant vulnerability factors for anxiety and early adult anxiety symptoms : The TOPP Study

Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18months to age 18–19years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety.

Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (β = 0.17, p<0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: β = 0.85,p<0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: β = 0.55,p<0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.

National identity in fragile states: insights from tertiary students in Melanesia and Timor-Leste

The challenges of nation building in Melanesia and Timor-Leste have often been neglected in the regional focus on state-building challenges. High levels of ethno-linguistic diversity, combined with an array of regional, historical and cultural divisions, continue to present obstacles to the creation of a cohesive sense of national political community leading these nations to be labelled ‘fragile’. This paper presents the findings of a comparative study on the attitudes of tertiary students in Melanesia and Timor-Leste to national identity and nation building. A strong pan-Melanesian pattern of group identification was identified, common to Papua New Guinea, Solomon Islands and Vanuatu. The ongoing importance of traditional authority and custom in informing conceptions of political community and identity was evident in all four case study sites, but was in each case matched by indicators of respect for modern state authority. The survey also reveals some significant gender differences in key attitudes towards national identity, including the role of traditional authorities. Most importantly, the study reveals high degrees of national pride, and faith in democratic principles and citizenship; but conversely, low levels of pride in contemporary democratic performance and inter-group tolerance.

Reconciling custom, citizenship and colonial legacies: Ni-Vanuatu tertiary student attitudes to national identity

Nation-building remains a key challenge in Vanuatu. From the origins of this new nation in 1980, it was clear that creating a unifying sense of national identity and political community from multiple languages and diverse traditional cultures would be difficult. This paper presents new survey and focus group data on attitudes to national identity among tertiary students in Vanuatu. The survey identifies areas of common attitudes towards nationalism and national identity, shared by both Anglophone and Francophone Ni-Vanuatu. However, despite the weakening ties between language of education and political affiliation over recent years, the findings suggest that there remain some key areas of strong association between socio-linguistic background, and attitudes to the nation, and national identity. These findings cast new light on the attitudes of likely future elites towards regional, ethnic, intergenerational and linguistic fault lines in Vanuatu and the challenges of building a cohesive sense of political community and national identity.

Patterns and correlates of self-reported racial discrimination among Australian Aboriginal and Torres Strait Islander adults, 2008–09: analysis of national survey data

Background
There is now considerable evidence that racism is a pernicious and enduring social problem with a wide range of detrimental outcomes for individuals, communities and societies. Although indigenous people worldwide are subjected to high levels of racism, there is a paucity of population-based, quantitative data about the factors associated with their reporting of racial discrimination, about the settings in which such discrimination takes place, and about the frequency with which it is experienced. Such information is essential in efforts to reduce both exposure to racism among indigenous people and the harms associated with such exposure.

Methods
Weighted data on self-reported racial discrimination from over 7,000 Indigenous Australian adults participating in the 2008–09 National Aboriginal and Torres Strait Islander Survey, a nationally representative survey conducted by the Australian Bureau of Statistics, were analysed by socioeconomic, demographic and cultural factors.

Results
More than one in four respondents (27%) reported experiencing racial discrimination in the past year. Racial discrimination was most commonly reported in public (41% of those reporting any racial discrimination), legal (40%) and work (30%) settings. Among those reporting any racial discrimination, about 40% experienced this discrimination most or all of the time (as opposed to a little or some of the time) in at least one setting. Reporting of racial discrimination peaked in the 35–44 year age group and then declined. Higher reporting of racial discrimination was associated with removal from family, low trust, unemployment, having a university degree, and indicators of cultural identity and participation. Lower reporting of racial discrimination was associated with home ownership, remote residence and having relatively few Indigenous friends.

Conclusions
These data indicate that racial discrimination is commonly experienced across a wide variety of settings, with public, legal and work settings identified as particularly salient. The observed relationships, while not necessarily causal, help to build a detailed picture of self-reported racial discrimination experienced by Indigenous people in contemporary Australia, providing important evidence to inform anti-racism policy.

Does diet-induced weight change effect anxiety in overweight and obese adults?

 Anxiety is the most prevalent type of mental disorder and a significant health concern. Crosssectional
studies have detected a positive association between obesity and anxiety. What is less
clear is whether weight loss can reduce anxiety. We sought to answer three questions:
1. Can weight loss improve symptoms of anxiety in the overweight and obese population?
2. Does the macronutrient content of energy-restricted diets that induce weight loss affect
anxiety?
3. Is the change in anxiety related to the amount of weight lost?
We investigated the findings from seven interventional studies, which induced weight loss by
dietary intervention, in overweight and obese individuals, using established anxiety assessment
tools. Mean weight loss ranged from 0.7 to 18.6 kg (SD 4.5) and in three of the studies, anxiety fell
by 9.2% to 11.4% and did not change in four studies. When macronutrient content was considered,
only one of four interventional studies and one pilot study reported a beneficial effect of a
moderate-fat diet on anxiety. There appears to be no strong evidence to indicate that diet-induced
weight loss has a beneficial effect on anxiety, however, none of the diet-induced weight loss
studies assessed had a detrimental effect on anxiety.

Depression, anxiety and metabolic syndrome in farm men and women

This research found that Depression was associated with the development of metabolic syndrome, whilst both Depression and Anxiety are associated with the maintenance of metabolic syndrome in Farm men and women. Future interventions in metabolic syndrome should consider screening for and treating these psychological factors to improve health outcomes.

The presence of mathematics anxiety in future primary school teachers and factors affecting abatement

This study reflects on the implementation of various teaching initiatives for reducing anxiety toward mathematics in students studying to become primary school teachers. We highlight similarities between these practices and those promoted by the 'Whole Teacher' approach - in particular, the aim to develop attitudes along with knowledge and skills. Here, the negative past associations with mathematics and anxiety toward mathematics that students bring with them have been a key consideration when designing the subject content and delivery. Given the important role these students will have in shaping mathematics education in the future, we suggest frameworks such as that of the 'Whole Teacher' could be extended to the university setting. We investigate four years of student feedback pertaining to a first year undergraduate mathematics unit, contending that the teaching initiatives introduced over time have helped students develop a positive attitude toward mathematics. We note, however, that the student-teacher relationship was still the most prominent factor directly identified by students who previously had a fear or negative attitude toward mathematics.

Higher social distress and lower psycho-social wellbeing:examining the coping capacity and health of people with hearing impairment

Abstract
Purpose: The objectives of this paper are as follows: (1) propose an explanatory model as to how hearing disability may impact on health and (2) examine the model’s utility.
Methods: Data were collected on the psycho-social wellbeing, disability and physical health of farmers (n=56) participating in an intervention to manage the social impacts of hearing disability. Two models were proposed and examined using multiple hierarchical linear regression. Model 1 used self-rated quality of life and model 2 used capacity to manage hearing and listening impairments, as dependent variables.
Results: The analyses found that physical measures of hearing impairment (audiograms) were not correlated with physical or mental health outcomes. However, in model 1, self-confidence and self-rated ability to manage hearing impairment were most closely associated with reduced quality of life (anxiety and diastolic blood pressure were positively associated with quality of life). In model 2, higher anxiety and reduced self-confidence were associated with decreasing ability to successfully manage one’s hearing impairment.
Conclusions: The findings support the explanatory model that stress is higher and wellbeing lower when the fit between the person’s coping capacity and environmental demands is poor.