Tess Knight

Biopsychosocial factors related to depression in aged care residents

BACKGROUND While depression is common in residential aged care settings, there is an absence of research into factors that may be associated with this condition. This pilot study examined the relationship between depression and multiple biopsychosocial factors among residents of aged care facilities. METHODS Participants were 50 aged care residents with a diagnosis of major depressive disorder, based on a clinical assessment using the SCID-I, and a matched sample of 50 residents without depression. The sample consisted of 80 women and 20 men without significant cognitive impairment, with a mean age of 83.0 years (SD=7.2 years). Participants completed a diagnostic interview with a clinical psychologist to determine the presence or absence of a mood disorder, and a set of scales related to demographics, depressive symptoms, physical health, functional disability, religiosity, and psychological wellbeing. RESULTS The unique predictors of scores on the Geriatric Depression Scale-15 were environmental mastery, purpose in life, and autonomy. These three variables discriminated between participants with and without a diagnosis of MDD with 80% accuracy. LIMITATIONS Findings were limited by the cross-sectional methodology and small sample size of cognitively intact English-speaking aged care residents. Replication is required with a prospective longitudinal design with a broader sample of residents. CONCLUSIONS Psychological variables were more important in understanding depression among aged care residents than traditional risk factors such as medical illness and disability. While preliminary, these findings highlight possible targets to prevent and treat depression in aged care settings.

An exploration of the well-being benefits of hedonic and eudaimonic behaviour

Hedonia and eudaimonia have both been proposed as pathways to well-being. Past research in this area has predominantly focused on global cognitive evaluations of how one typically lives. Findings from such research lack practical relevance, and hence, this study aimed to investigate how actual hedonic and eudaimonic behaviour related to well-being and psychopathology. Participants (N = 105) completed an array of well-being outcomes prior to completing an online diary, reporting actual instances of hedonic and eudaimonic behaviour. Participants spent more time engaged in hedonic activity than eudaimonic activity. Hedonic activity served an emotion regulation function, predicting positive affect, carefreeness, vitality, and life satisfaction. Hedonic behaviour also predicted reduced negative affect, depression, and stress. Eudaimonic behaviour predicted meaning in life and elevating experience. Both hedonic and eudaimonic behaviours predicted flourishing. These findings suggest that increasing hedonic and eudaimonic behaviours may be an effective way to increase well-being and reduce psychological distress.

Child support research in Australia : a critical review

Abstract The Australian Child Support Scheme impacts on the lives of many Australian families. Yet the Australian evidence base informing child support policy development is relatively sparse and lacks coherence. In this article, we employ an equity framework to consolidate the published Australian empirical child support research in order to identify gaps in current knowledge and assess the various layers of competing interest inherent therein. While researchers have begun to examine the financial outcomes of the new Australian Child Support Scheme, work is urgently needed to understand the effects that the new scheme has on children, payees and payers, and how these effects operate. We conclude by proposing an agenda for future Australian child support research that focuses on the aims of the scheme and the four equity principles we employ, namely, horizontal, vertical, gender, and intergenerational equity.

The Notion of Self in the Journey Back From Addiction

In this study we explored how those recovering from addiction negotiated self, and the role supported accommodation played in the journey back from addiction. Transcripts from 11 in-depth interviews were analyzed by 2 coders who identified the most salient themes relevant to the self in recovery within the personal contexts of participants. The participants noted that reclaiming the self that had been lost to addiction was of primary importance to them. The recovery journey exposed a self that had reached the lowest point in life; one that was hardly recognizable; one that was undesirable. Engaging with supported accommodation provided participants with a sanctuary within which to reclaim the self, and was seen as central to their recovery.

Body Image and Self-Esteem Among Asian, Pacific Islander, and White College Students in Hawaii and Australia

Body image and its relationship to self-esteem was examined among Asian, Pacific Islander, and White women and men from Hawaii and Australia (n = 172). Although Pacific Islander and White participants had higher body mass indices than Asians, Pacific Islanders were more satisfied than Asians with their health and more satisfied than Asians and Whites with their appearance. Thus, higher body weight and greater body satisfaction may co-occur among Pacific Islanders, whereas lower weight and lower body satisfaction may co-occur among Asians. The findings suggest different levels of risk for body image dissatisfaction, and its associated psychological consequences, across ethnic groups.

Facilitators' experience of delivering asynchronous and synchronous online interprofessional education.

Abstract Introduction: Online delivery of interprofessional education (IPE) is an emerging area with very little research to date focusing on the experience of the facilitator in this process. The purpose of this article was to explore the facilitator experience of online asynchronous and synchronous IPE facilitation of pre-licensure students. Methods: Nineteen online facilitators participated in semi-structured telephone interviews to explore this experience. Results: Findings from Interpretative Phenomenological Analysis indicated that the facilitators found positives of the experience including perceiving that the students were learning, their own development as a facilitator, the flexibility of the role and feeling supported as a facilitator. Challenges of the experience were also noted including technological problems in the synchronous environment and engaging some students or teams in both the synchronous and asynchronous environments. Discussion: While this study identified positive aspects of the facilitation experience it also highlighted some key topics which need to be addressed in training for online IPE facilitators to further enhance their experience, and subsequently the experience and interprofessional learning of their students.

The Act of Giving: A Systematic Review of Nonfamilial Intergenerational Interaction

Research fostering intergenerational interaction often promotes attitude change toward the other, social connectedness, service activities for younger adults, and older adults feeling purpose and valued. Research articles reporting projects designed using nonfamilial, reciprocal intergenerational interaction were systematically reviewed. Thirteen papers published between January 1990 and February 2012 in peer-reviewed, English-language publications met inclusion criteria. The review concluded that reciprocal giving needs to be structured into the methodology of future intergenerational studies for the full developmental opportunity of identity formation in younger adults, generativity in older adults, and psychosocial benefits for both generations to be realized.

Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: study protocol for a randomized controlled trial

BackgroundThere is increasing community and government recognition of the magnitude and impact of adolescent depression. Family based interventions have significant potential to address known risk factors for adolescent depression and could be an effective way of engaging adolescents in treatment. The evidence for family based treatments of adolescent depression is not well developed. The objective of this clinical trial is to determine whether a family based intervention can reduce rates of unipolar depressive disorders in adolescents, improve family functioning and engage adolescents who are reluctant to access mental health services.Methods/DesignThe Family Options study will determine whether a manualized family based intervention designed to target both individual and family based factors in adolescent depression (BEST MOOD) will be more effective in reducing unipolar depressive disorders than an active (standard practice) control condition consisting of a parenting group using supportive techniques (PAST). The study is a multicenter effectiveness randomized controlled trial. Both interventions are delivered in group format over eight weekly sessions, of two hours per session. We will recruit 160 adolescents (12 to 18 years old) and their families, randomized equally to each treatment condition. Participants will be assessed at baseline, eight weeks and 20 weeks. Assessment of eligibility and primary outcome will be conducted using the KID-SCID structured clinical interview via adolescent and parent self-report. Assessments of family mental health, functioning and therapeutic processes will also be conducted. Data will be analyzed using Multilevel Mixed Modeling accounting for time x treatment effects and random effects for group and family characteristics. This trial is currently recruiting. Challenges in design and implementation to-date are discussed. These include diagnosis and differential diagnosis of mental disorders in the context of adolescent development, non-compliance of adolescents with requirements of assessment, questionnaire completion and treatment attendance, breaking randomization, and measuring the complexity of change in the context of a family-based intervention.Trial registrationAustralia and New Zealand Clinical Trials Registry Title: engaging youth with high prevalence mental health problems using family based interventions; number 12612000398808. Prospectively registered on 10 April 2012.

Development of the Health Literacy of Caregivers Scale - Cancer (HLCS-C): item generation and content validity testing

BackgroundHealth literacy refers to an individual’s ability to engage with health information and services. Cancer caregivers play a vital role in the care of people with cancer, and their capacity to find, understand, appraise and use health information and services influences how effectively they are able to undertake this role. The aim of this study was to develop an instrument to measure health literacy of cancer caregivers.MethodContent areas for the new instrument were identified from a conceptual model of cancer caregiver health literacy. Item content was guided by statements provided by key stakeholders during consultation activities and selected to be representative across the range of cancer caregiver experiences. Content validity of items was assessed through expert review (n = 7) and cognitive interviews with caregivers (n = 16).ResultsAn initial pool of 82 items was generated across 10 domains. Two categories of response options were developed for these items: agreement with statements, and difficulty undertaking presented tasks. Expert review revealed that the majority of items were relevant and clear (Content Validity Index > 0.78). Cognitive interviews with caregivers suggested that all except three items were well understood.ConclusionA resultant 88 item questionnaire was developed to assess cancer caregiver health literacy. Further work is required to assess the construct validity and reliability of the new measure, and to remove poorly performing and redundant items, which will result in a shorter, final measure. The new measure has the potential to inform the development and evaluation of interventions and the improvement of health service delivery to cancer caregivers.

Family dissolution and offspring depression and depressive symptoms: A systematic review of moderation effects.

BACKGROUND Parental separation is associated with increased risk for offspring depression; however, depression outcomes are divergent. Knowledge of moderators could assist in understanding idiosyncratic outcomes and developing appropriately targeted prevention programs for those at heightened risk of depression following parental separation. Therefore, the objective of the review was to identify and evaluate studies that examined moderators of the relationship between parental separation and offspring depression METHODS A search of scientific, medical and psychological databases was conducted in April 2015 for longitudinal research that had evaluated any moderator/s of the relationship between parental separation or divorce and offspring depression or depressive symptoms. Papers were assessed for quality by evaluating the studys sample, attrition rates, methodology and measurement characteristics. RESULTS Fourteen quantitative studies from five countries assessed sixteen moderating factors of the relationship between parental separation and offspring depression or depressive symptoms. A number of factors were found to moderate this relationship, including offspring gender, age (at assessment and at depression onset), genotype, preadolescent temperament, IQ, emotional problems in childhood and maternal sensitivity. LIMITATIONS While robust longitudinal research was selected for inclusion, common issues with longitudinal studies such as low rates of participation and attrition were among the methodological concerns evident in some of the reviewed papers. CONCLUSIONS The current review is the first to assess interaction effects of the relationship between parental separation and offspring depression or depressive symptoms. While further research is recommended, this assessment is critical in understanding variation in heterogeneous populations and can inform targeted policy and prevention.