Mick Hunter

An evaluation of the Faces Pain Scale with young children.

The psychometric characteristics of the Faces Pain Scale (FPS) were evaluated in three groups of preschool and school-aged children (3. 5-4.5; 4.5-5.5 and 5.5-6.5 years, respectively). The FPS was adequately comprehended by even young children. It was easily administered and was valid and discriminating. It did not, however, possess the linear scalability claimed by its authors.

Vicarious traumatization in counsellors working in the New South Wales Sexual Assault Service: An exploratory study

Abstract A number of case reviews and observations have reported on the effects, on counsellors, of working with victims of violence. In this study two groups of counsellors, sexual assault counsellors (n = 41) and counsellors from a range of other therapy areas (n = 32), were compared on a number of measures including the Maslach Burnout Inventory, Ways of Coping Scale and a Beliefs and Values Questionnaire. The results indicate that sexual assault counsellors experience greater emotional exhaustion and use more escape/avoidance coping strategies. Responses concerning beliefs and values are discussed in terms of McCann and Pearlmans constructivist self-development model and indicate support for the concept of vicarious traumatization. Implications of these findings for Sexual Assault Services are discussed.

The Australian EEG Database

The Australian EEG Database is a web-based de-identified searchable database of 18,500 EEG records recorded at a regional public hospital over an 11-year period. Patients range in age from a premature infant born at 24 weeks gestation, through to people aged over 90 years. This paper will describe the history of the database, the range of patients represented in the database, and the nature of the text-based and digital data contained in the database. Preliminary results of the first two studies undertaken using the database are presented. Plans for sharing data from the Australian EEG database with researchers are discussed. We anticipate that such data will be useful in not only helping to answer clinical questions but also in the field of mathematical modeling of the EEG.

Distinguishing childhood absence epilepsy patients from controls by the analysis of their background brain electrical activity (II): a combinatorial optimization approach for electrode selection

In this sequel to our previous work [Rosso OA, Mendes A, Rostas JA, Hunter M, Moscato P. Distinguishing childhood absence epilepsy patients from controls by the analysis of their background brain electrical activity. J. Neurosci. Methods 2009;177:461-68], we extend the analysis of background electroencephalography (EEG), recorded with scalp electrodes in a clinical setting, in children with childhood absence epilepsy (CAE) and control individuals. The same set of individuals was considered-five CAE patients, all right-handed females and aged 6-8 years. The EEG was obtained using bipolar connections from a standard 10-20 electrode placement. The functional activity between electrodes was evaluated using a wavelet decomposition in conjunction with the Wootters distance. In the previous study, a Kruskal-Wallis statistical test was used to select the pairs of electrodes with differentiated behavior between CAE and control samples (classes). In this contribution, we present the results for a combinatorial optimization approach to select the pairs of electrodes. The new method produces a better separation between the classes, and at the same time uses a smaller number of features (pairs of electrodes). It managed to almost halve the number of features and also improves the separation between the CAE and control samples. The new results strengthen the hypothesis that mostly fronto-central electrodes carry useful information and patterns that can help to discriminate CAE cases from controls. Finally, we provide a comprehensive set of tests and in-depth explanation of the method and results.

The role of resilience in adjustment and coping with chronic pain.

PURPOSE In clinical practice, it is often noted that some individuals struggle with chronic pain, while others find effective means to cope. The purpose of this study was to better understand how resilience fits into coping with persistent pain problems. Of interest was whether measures of resilience add to the prediction of adjustment to chronic pain over and above measures of pain coping as typically used with this patient group. METHOD Individuals (N = 101) with chronic pain who attended an initial assessment at a pain clinic completed self-report measures of resilience and coping. Pain related outcome data were also collected. RESULTS Bivariate correlations indicated that higher resilience was associated with significantly less fear avoidance, less pain-related disability, and lower reported pain intensity. Consistent with theoretical propositions, bivariate analyses also indicated that more resilient individuals with chronic pain reported better social support, and were more likely to be working. Higher resilience was also positively correlated with greater pain self-efficacy. However, when hierarchical regression analyses were performed, resilience did not add significantly to the prediction of depression scores and disability scores, over and above the contribution made by existing measures of pain coping. CONCLUSION These findings suggest that, although the construct of resilience appears to have important relationships with various dimensions of chronic pain, as currently operationalized, it does not add significantly to the understanding of chronic-pain adjustment. Rather than abandoning the resilience construct, our findings suggest that resilience as applied to the problem of chronic pain may require a refinement in measurement with this population.

Study of EEG Brain Maturation Signals with Multifractal Detrended Fluctuation Analysis

In this work, we have study the EEG signals of birds during the first 6 weeks of life. The aim of the article is to perform a quantitative analysis of the dynamical changes observed in these signals due to the brain maturation effects. The signals’ long scaling behaviour is study by Multifractal Detrended Fluctuation Analysis (MFDFA). This method allows the multifractal characterization of these EEG nonstationary time series and characterize the different stage of bird brain maturation.

Hypertension and asthma: Psychological aspects

Essential hypertensive and asthmatic patients, plus normal non-clinical controls, were compared on a number of psychological measures in order to identify the relationship between psychological distress, coping strategies and compliance behaviour. The hypothesised relationship between chronic clinical ailments and psychological distress was confirmed. The association between the presence of physical symptoms in the symptomatic condition, asthma, and greater psychological distress was also confirmed. The coping strategies adopted by the patients did not discriminate between the two clinical groups. Compliance with medication was negatively correlated with measures of psychological distress. Compliance with an appropriate healthy lifestyle was not correlated with medication compliance, although it too was negatively correlated with other measures of psychological distress.

Distinguishing childhood absence epilepsy patients from controls by the analysis of their background brain electrical activity

Background electroencephalography (EEG), recorded with scalp electrodes, in children with childhood absence epilepsy (CAE) and control individuals has been analyzed. We considered 5 CAE patients, all right-handed females and aged 6-8 years. The 15 control individuals had the same characteristics of the CAE ones, but presented a normal EEG. The EEG was obtained using bipolar connections from a standard 10-20 electrode placement (Fp1, Fp2, F7, F3, Fz, F4, F8, T3, C3, Cz, C4, T4, T5, P3, Pz, P4, T6, O1 and O2). Recordings were undertaken in the resting state with eyes closed. EEG hallmarks of absence seizure activity are widely accepted, but there is a recognition that the bulk of interictal EEG in CAE appears normal to visual inspection. The functional activity between electrodes was evaluated using a wavelet decomposition in conjunction with the Wootters distance. Then, pairs of electrodes with differentiated behavior between CAE and controls were identified using a test statistic-based feature selection technique. This approach identified clear differences between CAE and healthy control background EEG in the frontocentral electrodes, as measured by Principal Component Analysis. The findings of this pilot study can have strong implications in future clinical practice.

Ten-year audit of clients presenting to a specialised service for young people experiencing or at increased risk for psychosis

BackgroundDespite strong research interest in psychosis risk identification and the potential for early intervention, few papers have sought to document the implementation and evaluation of specialised psychosis related services. Assessment of Ultra High Risk (UHR) has been given priority, but it is equally as important to identify appropriate comparison groups and other baseline differences. This largely descriptive service evaluation paper focuses on the `baseline characteristics’ of referred clients (i.e., previously assessed characteristics or those identified within the first two months following service presentation).MethodsData are reported from a 10-year layered service audit of all presentations to a `Psychological Assistance Service’ for young people (PAS, Newcastle, Australia). Baseline socio-demographic and clinical characteristics (N =1,997) are described (including clients’ psychosis and UHR status, previous service contacts, hospitalisation rates, and diagnostic and comorbidity profiles). Key groups are identified and comparisons made between clients who received ongoing treatment and those who were primarily assessed and referred elsewhere.ResultsClients averaged 19.2 (SD =4.5) years of age and 59% were male. One-tenth of clients (9.6%) were categorised as UHR, among whom there were relatively high rates of attenuated psychotic symptoms (69.1%), comorbid depression (62.3%), anxiety (42.9%), and attentional and related problems (67.5%). Overall, one-fifth (19.8%) experienced a recent psychotic episode, while a further 14.5% were categorised as having an existing psychosis (46.7% with a schizophrenia diagnosis), amongst whom there were relatively high rates of comorbid substance misuse (52.9%), psychosocial (70.2%) and physical health (37.7%) problems. The largest group presenting to PAS were those with non-psychotic disorders (43.7%), who provide a valuable comparison group against which to contrast the health trajectories of those with UHR and recent psychosis. Ongoing treatment by PAS was preferentially given to those experiencing or at risk for psychosis and those reporting greater current distress or dysfunction.ConclusionsWhether or not UHR clients transition to psychosis, they displayed high rates of comorbid depression and anxiety at service presentation, with half receiving ongoing treatment from PAS. Although international comparisons with similar services are difficult, the socio-demographic and comorbidity patterns observed here were viewed as largely consistent with those reported elsewhere.

Improving antenatal risk assessment in women exposed to high risks

Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview – Revised Short Version) and mother–infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the ‘exposed to high risks’ group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women ‘exposed to high risks’ were equally able to generate a model of their own and their infants’ mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups.