Greg Shuttlewood

Cohort Profile Update: The Mater-University of Queensland Study of Pregnancy (MUSP)

The Mater-University of Queensland Study of Pregnancy (MUSP) and its outcomes began in 1981 with data collected on 7223 pregnant woman-child pairs (6753 mothers, of whom 520 had 2 study children, less 50 who had multiple births). These women, and their children, were initially followed for up to 21 years. Since then there have been additional follow-ups of the mothers (27 years) and their children (30 years). There has also been a substantial increase in the breadth of topics addressed, with the collection of biological samples, the administration of structured clinical assessments of mental health and cognitive capacity, and markers of physical health such as lung function and blood pressure. MUSP was originally developed as a birth cohort study. It has become a longitudinal study of growth, development and ageing with an emphasis on the generational transmission of a wide range of factors impacting on adult health outcomes. We welcome interest in our study; for study background and publications visit [www.socialscience.uq.edu.au/musp] or contact [j.najman@uq.edu.au].

Bias influencing maternal reports of child behaviour and emotional state

Background: Previous research has indicated that there may be only a modest degree of agreement between different reporters of a childs behaviour (mental health). This raises the possibility that some descriptions of the childs behaviour may reflect the personal characteristics of the respondent. We examine two potential sources of bias that may influence reports of a childs behaviour/mental health. The first is the mental or emotional impairment of the respondent; the second concerns gender-related expectations of children. Methods: Mothers (and their children after the birth) were assessed at first clinic visit, 3–5 days after the birth, then 6 months, 5 years and 14 years after the birth. Some 70% of respondents giving birth remained in the study at the 14-year follow-up, leaving some 5277 cases for this analysis. At the 14-year follow-up, child behaviour (mental health) was assessed using the Child Behaviour Check List and the Youth Self Report. Maternal mental health was determined using the anxiety and depression subscales of the Delusions-Symptoms-States Inventory. Results: Mothers who were not emotionally impaired reported fewer child behaviour problems than did the children themselves. As the mothers current emotional impairment increased, so her reports of the childs behaviour problems increased, when compared with the childs own reports. Further, mothers attributed more internalising symptoms to female respondents, and more externalising symptoms to male respondents, than did the child respondents themselves. Conclusions: Mothers differ systematically from their children when they are reporting their childs behaviour (mental health). The more emotionally impaired the mother, the greater the degree to which she imputes the child to have behaviour problems. Further, female children are attributed to have more internalising behaviours and male children externalising behaviours.

Early Childhood Factors Influencing Health-Related Quality Of Life In Adolescents At 13 Years

Objective:  To understand the relationship of health‐related quality of life (HR‐QOL) to early life experience.

Specific and nonspecific factors in psychotherapy: A case of cognitive therapy for depression

Abstract The literature has succeeded in showing that psychotherapy in general is more effective than no-treatment conditions, but it has not clearly demonstrated differences in outcome efficacy between psychotherapies. One prominent explanation for equivalent treatment outcome efficacy is the placebo effect. The origins of the placebo effect, its evolution, and the debate surrounding it are discussed. It is argued that the placebo effect is not useful for the understanding and advancement of psychotherapy. It is proposed that examination of specific and nonspecific factors with regard to individual therapies will be of more utility. Specific factors refer to elements clearly delineated by proponents of a given therapy as the active causes of change. Nonspecific factors refer to possible elements in one therapy that contribute to improvement but which are not specified in the theoretical or practical delineation of the therapy. Cognitive therapy for depression is posited to be a suitable vehicle for examining specific and nonspecific factors in psychotherapy. Therefore, evidence for specific factors and nonspecific factors is considered in the context of Becks cognitive models and therapy. The literature appears to suggest that both specific and nonspecific factors are influential. Our own study suggests that specific factors are more influential in the change occurring in cognitive therapy. However, action of these specific factors are not unique to cognitive therapy. Until evidence is forthcoming to show presence of elements both specific and unique to differing psychotherapies, the issue of reasons for treatment efficacy will remain controversial.

Comparison of specific and nonspecific factors in a group cognitive therapy for depression

Research into the efficacy of psychotherapy has often reported equivalence in treatment outcome when comparing different therapies. These findings have been interpreted as evidence for what are variously termed placebo, common or nonspecific processes. We suggested that this issue is best examined in comparison of specific and nonspecific processes in the action of a specified therapy and disorder. No comparisons of this nature have yet been reported in relation to cognitive therapy for depression. This study compared specific processes (automatic thoughts and dysfunctional attitudes) and major common processes (satisfaction with therapy and client evaluation of therapist) in the action of a group cognitive therapy for depression. Sixty patients suffering from major depression received a 12 week course of group cognitive therapy. Results from hierarchical regression suggested that the specific processes of cognitive therapy were more associated with reduction in depression than common processes which contributed to the prediction of reduction in depression via specific processes.

Development of a Satisfaction with Therapy and Therapist Scale.

Objective: While much work has gone into developing measures of specific factors in psychotherapy for depression, measures for non-specific factors have been lacking. This paper aims to develop a scale for a non-specific factor called ‘Satisfaction with Therapy and Therapist Scale’. Method: Sixty-seven patients with major depression completed the questionnaires during the fourth session of cognitive therapy. The patients went through an assessment clinical interview using a SCID. They also completed the ATQ, BDI and DAS questionnaires during the fourth session. Results: Principal component factor analysis with varimax rotation showed that the scale possesses two factors, ‘Satisfaction with Therapy’ and ‘Client Evaluation of Therapist’, accounting for 64.7% of the total variance. The alpha Cronbach for the two factors is 0.91 and 0.80 with the total scale alpha at 0.90. The scale also possesses good concurrent and disciminant validity. Conclusion: The Satisfaction with Therapy and Therapist Scale is an adequate measure for measuring a non-specific factor in psychotherapy.