Helen M. Stallman

Psychological distress in university students: A comparison with general population data

Objective: While the mental health of university students is recognised internationally as an important public health issue, more epidemiological data are needed that allows benchmarking with general population data. Methods: All enrolled students from two large Australian universities were invited to complete a web-based survey. Anxiety-mood disorders were assessed using the Kessler 10. A total of 6,479 students participated in the study with sociodemographics generally consistent with the university population. Results: The estimated prevalence for mental health problems was 19.2% with 67.4% reporting subsyndromal symptoms. These rates were significantly higher than the general population. Psychological distress was associated with disability and lower academic achievement. Predictors of distress included: full-time status, financial stress, being aged between and 18 and 34 years, being female, and in a subsequent undergraduate year of their degree. Conclusions: The extremely high prevalence of mental health problems in university students provides evidence for this being an at-risk population. Implications: The results highlight the need for universal early interventions to prevent the development of severe mental illness in university students.

Online Alcohol Interventions: A Systematic Review

Background There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer*; (3) alcohol*; and (4) E\effect*, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.

Universal online interventions might engage psychologically distressed university students who are unlikely to seek formal help

Abstract University students are a high risk population for mental health problems, yet few seek professional help when experiencing problems. This study explored the potential role of an online intervention for promoting wellbeing in university students, by investigating students’ help-seeking behaviour, intention to use online interventions and student content preference for such interventionss; 254 university students responded to an online survey designed for this study. As predicted, students were less likely to seek help as levels of psychological distress increased. Conversely, intention to use an online intervention increased at higher levels of distress, with 39.1%, 49.4% and 57.7% of low, moderate and severely distressed students respectively indicating they would use an online program supporting student well-being. Results suggest that online interventions may be a useful way to provide help to students in need who otherwise may not seek formal help.

Embedding Resilience within the Tertiary Curriculum: A Feasibility Study.

Mental health problems can significantly impact on the ability of university students to both meet their individual potential and contribute positively within society. This study evaluates the feasibility of embedding a strength‐focused resilience‐building seminar within a university curriculum. Participants were 247 students enrolled in an undergraduate psychology subject. The Staying on Track seminar, consisting of six building blocks for resilience, was delivered within a normal lecture period. Students completed post‐measures on satisfaction and usefulness, as well as follow‐up reflective journals entries noting changes made as a result of seminar participation. The seminar received high scores for satisfaction and 90% of students reported at least one of the six building blocks as being useful to them. Satisfaction also translated into self‐reported positive behaviour change for many students. Implications for the role of curriculum‐based resilience‐building programs within universities are discussed.

Vulnerability factors for disaster-induced child post-traumatic stress disorder: the case for low family resilience and previous mental illness

Objective: The aim of the present study was to investigate whether parent report of family resilience predicted childrens disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. Methods: A total of 568 children (mean age = 10.2 years, SD = 1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)–emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Sixty-four students (11.3%) were in the severe–very severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (ORadj) = 0.57, 95% confidence interval (CI) = 0.13–2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (ORadj = 0.75, 95%CI = 0.16–3.61). Conclusion: In this post-disaster sample children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed.

Reducing risk factors for adolescent behavioural and emotional problems: A pilot randomised controlled trial of a self-administered parenting intervention

Abstract Parenting practices and parent-child relationships affect adolescent adjustment. This study examined the efficacy of a self-directed parenting intervention for 51 parents of early adolescents (aged 12–14 years), who reported experiencing difficulties with their adolescent’s behaviour. Two levels of intensity of a self-directed intervention (self-directed alone and self-directed plus brief therapist telephone consultations) were compared with a waitlist control group. At post-intervention, parents in the enhanced condition reported significantly fewer adolescent behavioural problems and less use of over-reactive parenting strategies than parents in either the standard or waitlist conditions. Improvements were maintained at 3-month follow-up. This research suggests that a self-directed behavioural family intervention with minimal therapist contact may be an effective early intervention for adolescent problems. It has implications for providing minimally sufficient interventions for parents using a multilevel approach to intervention as well as for making interventions more accessible for families.

Workplace Triple P: A Controlled Evaluation of a Parenting Intervention for Working Parents

This paper examined the effects of a parenting intervention targeting working parents called Workplace Triple P. The intervention targeted both parenting and work factors, focusing on key transition times (e.g., from home to work) and trained parents to more effectively manage these transitions. One-hundred-and-twenty-one working parents with children ranging in age from 1-16 years were randomly assigned to either a Workplace Triple P condition (WPTP) or to a waitlist control condition (WLC). Results showed that parents who had received the intervention reported significantly lower levels on measures of personal distress and dysfunctional parenting; and higher levels of work commitment, work satisfaction, and self-efficacy. Implications for the delivery of parenting interventions as employee assistance programs are discussed along with how such interventions can enhance work and family life.

Family transitions Triple P : The theoretical basis and development of a program for parents going through divorce

Abstract Divorce is a major life Stressor and life transition for parents and children. It places parents and children at risk of developing psychological problems that can have long-term negative consequences for children. Family Transitions Triple P is an adaptation of Triple P-Positive Parenting Program that has been specifically developed to address risk factors and enhance protective factors for parents who are divorced. This paper presents the rationale, theoretical foundations, historical development, and distinguishing features of this program. The multilevel intervention promotes parental self-sufficiency, self-efficacy, self-management skills, personal agency, and problem-solving skills to promote short- and long-term positive outcomes for children and parents after divorce.

A Randomized Controlled Trial of Family Transitions Triple P: A Group-Administered Parenting Program to Minimize the Adverse Effects of Parental Divorce on Children

This randomized controlled trial evaluated the efficacy of Family Transitions Triple P (FTTP), a 12-session, group-delivered positive parenting program designed to prevent adverse outcomes for children following parental divorce. Participants were 204 parents who had been divorced less than 2 years and had a child ages 2 to 14 years. Parents were randomized into 1 of 3 conditions: FTTP–E with enhanced engagement, FTTP–S with standard engagement, or waitlist control. Interventions were delivered through community relationship centers by relationship counselors. Results showed that parents in the FTTP conditions reported significantly greater reductions in child behavior problems and coercive parenting compared to the waitlist control condition. There were no significant differences between the FTTP–E and FTTP–S conditions. At 12-month follow-up for both FTTP intervention groups, there were sustained improvements in the levels of parental distress (depression, anxiety, stress, and anger) and improvements in coparent communication and acrimony. Implications of findings are discussed.

Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis.

Sleepwalking is thought to be a common arousal disorder; however, the epidemiology of this disorder has not yet been systematically examined. A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted for ‘sleepwalking’ OR ‘somnambulism’ in any field, to identify studies that reported the epidemiology of sleepwalking or sleepwalking disorders. Fifty-one studies assessed the prevalence rates of sleepwalking in a total sample of 100 490. The meta-analysis showed the estimated lifetime prevalence of sleepwalking was 6.9% (95% CI 4.6%–10.3%). The current prevalence rate of sleepwalking—within the last 12 months—was significantly higher in children 5.0% (95% CI 3.8%–6.5%) than adults 1.5% (95% CI 1.0%–2.3%). There was no evidence of developmental trends in sleepwalking across childhood. The significant risk of bias across all studies suggests these results should be used cautiously. Further epidemiological research that addresses methodological problems found in studies of sleepwalking to date is needed.