Special interests and mental health in autism spectrum disorders

Special interests (SIs) in autism spectrum disorders are a prevalent though relatively under-researched phenomenon. There was partial support for the hypotheses and factors influencing the relationship between SIs and mental health were identified. Findings contribute to a better understanding of SIs including their importance for individuals with ASD.

Impact of depression treatment on mental and physical health-related quality of life of cardiac patients : a meta-analysis

PURPOSE: To conduct a meta-analysis evaluating the effectiveness of depression treatment on mental and physical health-related quality of life (HRQOL) of cardiac patients.

METHODS: Studies were identified using medical, health, psychiatry, psychology, and social sciences databases. Inclusion criteria were (1) 1 or more control conditions, (2) random assignment to condition after admission for myocardial infarction (MI)/acute coronary syndrome, after recording positive results on a depression screener, (3) documentation of depression symptoms at baseline, (4) depression management as a component of the rehabilitation/intervention, (5) validated measure of HRQOL as an outcome, at minimum 6-month followup. For meta-analysis, mental and physical HRQOL were the end points studied, using standardized mean differences for continuous outcome measures, with 95% confidence intervals. Heterogeneity was explored by calculating I2 statistic.

RESULTS: Five randomized controlled trials included in the analysis represented 2105 participants (1058 intervention vs 1047 comparator). Compared with a comparator group at 6 months, a test for overall effect demonstrated statistically significant improvements in mental HRQOL in favor of the intervention (standardized mean differences = −0.29 [−0.38 to −0.20], [P < .00001]; I2 = 0%). Depression treatment had a modest yet significant impact on physical HRQOL (standardized mean differences = −0.14 [−0.24 to −0.04] [P = .009]; I2 = 15%).

CONCLUSION: While the impact of post-MI depression interventions on physical HRQOL is modest, treatment can improve mental HRQOL in a significant way. Future research is required to develop and evaluate a program that can achieve vital improvements in overall HRQOL, and potentially cardiovascular outcomes, of cardiac patients.

Obsessive compulsive disorder : integration of cognitive-behaviour therapy and clinical psychology care into the primary care context

In primary care, evidence-based psychological treatments for obsessive compulsive disorder (OCD), such as cognitive behaviour therapy (CBT), have not been readily available. We aimed to develop models of care for OCD that account for barriers to access and can be integrated into general practice settings. Multiple methodologies and sources were utilised, including literature reviews, a reference group, focus groups, interviews and questionnaire responses from consumers, psychologists and/or GPs. It was found that there were similarities and some differences among stakeholders in attitudes and knowledge about OCD, and views about treatment and assessment in primary care. Three models of care for patients with OCD were developed and integrated into a treatment program operating through a division of general practice. Participating GPs preferred referral to a specialist clinic, irrespective of participation in an educational program about OCD. Based on these findings, it is suggested that effective integration of specialist CBT treatments for OCD into primary care is possible if the needs and views of all stakeholders are accounted for.

Competing ethical paradigms in forensic psychiatry and forensic psychology: commentary for a special section of legal and criminological psychology

In her paper Gwen Adshead (2013) identifies the principle of respect for justice as the foundation for ethical practice in forensic psychiatry. This commentary discusses how forensic psychologists have approached a key aspect of the justice principle, the ethical imperative to promote the welfare of the individual client. The approaches of the psychiatric and psychological professions are compared and the role of psychologists as allied health professionals working in the forensic setting considered.

Barriers and enablers to clinical fieldwork education in rural public and private allied health practice

There is a need to maximise rural clinical fieldwork placement to build health workforce capacity. This study investigated allied health professionals' (AHPs) experience of supervising students as part of work-integrated learning in public and private rural health settings. An anonymous postal questionnaire with 30 questions was used to collect quantitative and qualitative data about the barriers and enablers that AHPs encounter when supervising students in their clinical setting. A total of 113 public and private AHPs from Southwest Victoria, Australia, returned the questionnaire. The AHPs were trained in the disciplines of occupational therapy, physiotherapy, speech pathology, dietetics, podiatry or psychology. The majority of respondents (75%) had previously supervised students. Most respondents had only provided fieldwork education in the public sector. Allied health professionals working in public and private sectors had positive experiences with clinical fieldwork education and often had increased job satisfaction while supervising students. They experienced similar enablers to involvement in clinical fieldwork education programs, however the barriers they encountered were different. The findings highlight the differing issues between rural public and private settings that need to be addressed for successful clinical fieldwork education and work-integrated learning. Strategies to address the identified barriers need to be specific to the work conditions of each setting.

The potential utility of Daoist theory and practice in psychology

This thesis attempted to demonstrate the potential for adaptation from the Chinese philosophical tradition of Daoism into modern psychology. The candidate was able to succesfully demonstrate a link between Daoist thinking style and reduced stress levels, especially in Chinese individuals.

Gratitude : a basis for positive psychology interventions with a clinical population

This thesis includes a literature review that summarises the types of psychological research that have been conducted into gratitude, including the research conceptualising and developing assessments around it and exploring its associations with wellbeing, personality, social interaction, and health. The review focuses specifically on the research examining the relationship of gratitude to anxiety, depression and sleep, providing an outline of current theories about the relationship of positive affect to wellbeing, and a summary of the evidence to date. It is noted that there is comparatively little research on the impact of gratitude on anxiety and sleep but promising findings about the role of gratitude in the treatment of depression. Taken together, it is argued, the current research supported the need for trials of gratitude interventions specifically with clinical populations. Finally, the review looks at the literature of experimental interventions using gratitude. Particular emphasis is given to what has been learnt through these trials that might guide the focus and design of future research.

There follows the report of a randomized wait-list controlled pre-post trial of a gratitude diary intended to extend the research into the efficacy of gratitude diaries in the treatment of clinical populations with depression, anxiety and sleep difficulties. It was hypothesised that after completing a brief gratitude diary for three weeks, participants would have lower scores on measures of depression, anxiety, and perceived sleep difficulties, and higher scores on a measure of life satisfaction. These results were also expected to be evident at three-week follow-up. In a randomised waitlist-controlled trial with repeated measures pre-, post- and follow-up design, participants (N=109, from Australia) aged 18-64 years with a current self-reported diagnosis of an anxiety disorder and/or depression, took part in a self-help study via the internet. After completing the diary participants had lower scores on measures of depression, anxiety and perceived sleep difficulties and higher scores on a measure of subjective wellbeing than immediately pre-intervention. In addition, they had improved scores on a measure of stress. At three-week follow-up scores on depression and perceived sleep difficulties were no longer significantly different from pre-intervention, however improvements for subjective wellbeing and stress at post-intervention were maintained. At follow-up scores for anxiety had not only been maintained but had improved significantly beyond post-intervention results. This trial provides support for the use of gratitude diaries as a short-term intervention with a clinical population. Different patterns of anxiety and depression scores raise the possibility that gratitude interventions work differently to address depression and anxiety symptoms and provide support for the idea that gratitude interventions may have sustainable effects on anxiety symptoms.

Adolescent peer group orientation, parent/attachment styles and mental health

Jennette Robinson’s research examined peer group characteristics and their relationship to parent/peer attachment, parenting styles, and adolescent functioning. Secure parental attachments were not associated with easier group access or participation in a greater number of groups. Evidence supported a relationship between parenting style and both group establishment and membership hierarchy.

Improving the outcomes of the South Australian mental health court: an examination of the predictors of success

 This thesis investigated the role that mental health problem-solving courts play within the Australian criminal justice system. It demonstrated that these courts can be an effective solution in the delivery of effective justice responses to vulnerable offenders, if administered in a manner that focuses on risk rather than clinical variables.

Workplace stress: what is the role of positive mental health?

To examine whether positive mental health (PMH)-a positively focused well-being construct-moderates the job stress-distress relationship.

Mental health diversion courts: a two year recidivism study of a South Australian mental health court program.

The need to develop specialized judicial processes to deal with offenders with mental illnesses is now widely recognized and has led to the introduction of mental health court diversion programs around the world. At present, however, there is only limited evidence from which to assess the impact of these initiatives. This paper describes the South Australian model of diversion, with specific reference to the relationship between identified participant characteristics, program compliance rates, and re-offending outcomes. The results of a two-year recidivism study suggest that involvement with the program has a positive impact on recidivism, but that this is independent from the individual's level of success in the program. Lower risk offenders were more likely to achieve successful outcomes than those in the higher risk categories. The implications of these results, as well the factors that might inform the ongoing development of mental health court programs, are discussed.