Feasibility and acceptability of a remotely delivered transdiagnostic CBT treatment for postnatal anxiety and related disorders: A pilot case series

Women in the postnatal period are at a high risk of developing clinically significant symptoms of anxiety. Cognitive behavioural therapy is effective in the treatment of postnatal anxiety; however, there are many barriers to accessing this treatment. This study examined the feasibility and acceptability of transdiagnostic cognitive behavioural therapy delivered remotely via Internet videoconferencing. Three women (Mage = 28.33 years; SD = 4.04) with a postnatal anxiety-related disorder were treated using the videoconference-delivered cognitive behavioural therapy. The treatment was delivered once per week over a 5-week period. All participants met criteria for clinically significant change in anxiety symptoms at post-treatment, and one participant met criteria for clinically significant change in depressive symptoms, which was maintained at 3-month follow-up. The intervention was also found to be acceptable by participants. The results provide preliminary feasibility evidence of the clinical utility and acceptability of remotely delivered transdiagnostic cognitive behavioural therapy as an intervention for postnatal anxiety disorders

Associations between defence-style, eating disorder symptoms, and quality of life in community sample of women : a longitudinal exploratory study

Background and Aim: Eating Disorders (EDs) impact an estimated 15% of the global population and are linked to maladaptive defence-styles (coping strategies) and poorer mental health outcomes. Defence-styles have been grouped into immature, neurotic, and mature behaviours. Studies have yet to examine all three defence-styles in ED symptomatic individuals over an extended period of time. The current study aimed to investigate using converse analysis the relationships between defence-style and ED outcomes over a 5-years period. Methods: Participants (n = 216, mean age 33 years) were recruited through the Women’s Eating and Health Literacy study, with the current study examining a 5-years period of two waves (year-4 and year-9). The current study tested associations over time between eating pathology (EDE-Q), psychological distress (K10), mental and physical health related quality of life (M/PHRQoL, SF-12), and defence-style (DSQ-40). Results: Mature, immature and neurotic defence-styles did not significantly change over 5 years. Over the same period, only PHRQoL significantly predicted mature defence-styles having positive effect. Both MHRQoL and PHRQoL significantly predicted immature defence-styles having positive and negative effects, respectively. Psychological distress, PHRQoL and weight concern significantly predicted neurotic defence-styles having positive effects except for psychological distress. PHRQoL, MHRQoL, restraint and eating concern significantly predicted overall eating pathology having positive effects except for PHRQoL and MHRQoL. Conversely, among the defence-style variables, over 5 years, both immature and neurotic defence-styles significantly predicted psychological distress having positive effects, immature and mature defence-styles significantly predicted MHRQoL having negative and positive effects, respectively, while only immature defence-styles significantly predicted overall eating pathology having positive effect. Conclusions: The results of the current study suggest that immaturity and neuroticism but not maturity were the defence-style variables predicting psychological distress over a 5-years period while conversely psychological distress predicted only neurotic defence styles. The findings of the current study may suggest that without intervention, mature, immature and neurotic defence-styles may largely remain immutable to significant shifts over time. Limitations in the current study included limited demographic representation. The current study is anticipated to generate considerations into treatments that could strengthen defence-styles in individuals with increased eating pathology

Feasibility and acceptability of a remotely delivered transdiagnostic CBT treatment for postnatal anxiety and related disorders: A pilot case series

Women in the postnatal period are at a high risk of developing clinically significant symptoms of anxiety. Cognitive behavioural therapy is effective in the treatment of postnatal anxiety" however, there are many barriers to accessing this treatment. This study examined the feasibility and acceptability of transdiagnostic cognitive behavioural therapy delivered remotely via Internet videoconferencing. Three women (Mage=28.33years; SD=4.04) with a postnatal anxiety-related disorder were treated using the videoconference-delivered cognitive behavioural therapy. The treatment was delivered once per week over a 5-week period. All participants met criteria for clinically significant change in anxiety symptoms at post-treatment, and one participant met criteria for clinically significant change in depressive symptoms, which was maintained at 3-month follow-up. The intervention was also found to be acceptable by participants. The results provide preliminary feasibility evidence of the clinical utility and acceptability of remotely delivered transdiagnostic cognitive behavioural therapy as an intervention for postnatal anxiety disorders

Classifying excessive exercise: Examining the relationship between compulsive exercise with obsessive‐compulsive disorder symptoms and disordered eating symptoms

Objective: There remains a lack of consensus around nosology for compulsive exercise (CE). Although widely observed in eating disorders (ED), CE shares theoretical overlap with obsessive‐compulsive disorder (OCD), where exercise compulsions occur in response to obsessions. Yet, there is limited and mixed evidence of a relationship between CE with OCD. This study aims to explore the appropriate diagnostic classification of CE through examination of CE in relation to OCD, obsessional thinking, and ED symptoms. Method: Two hundred and eighty one adults with mental health symptoms, dieting, and exercise behaviour completed measures of OCD, CE, and disordered eating symptoms. Regression and Receiver Operating Characteristic analyses examined relationships between dimensions of CE with OCD and ED symptoms, and the predictive ability of CE assessment for detecting threshold OCD and ED symptoms. Results: CE assessment was poor at predicting threshold OCD symptoms, probable Anorexia Nervosa, and Binge Eating Disorder and moderate at detecting probable disordered eating and Bulimia Nervosa. Associations between CE and OCD symptoms were not significant after adjustment for ED symptoms. Obsessional thinking was associated only with lack of exercise enjoyment. Conclusions: Results indicate that excessive exercise might represent a distinct disorder, with some shared traits across CE, OCD and ED symptoms. Findings question the utility of adaptation of OCD diagnostic criteria for CE. Assessment and treatment implications are considered

Australian Youth Mental Health and Climate Change Concern After the Black Summer Bushfires

Climate change and its effects present notable challenges for mental health, particularly for vul-nerable populations, including young people. Immediately following the unprecedented Black Summer bushfire season of 2019/2020, 746 Australians (aged 16–25 years) completed measures of mental health and perceptions of climate change. Results indicated greater presentations of depression, anxiety, stress, adjustment disorder symptoms, substance abuse, and climate change distress and concern, as well as lower psychological resilience and perceived distance to climate change, in participants with direct exposure to these bushfires. Findings highlight significant vulnerabilities of concern for youth mental health as climate change advances

Commentary: An Extension of the Australian Postgraduate Psychology Education Simulation Working Group Guidelines: Simulated Learning Activities Within Professional Psychology Placements

A Commentary on The use of simulated patients in medical education: AMEE Guide No 42 by Cleland, J. A., Abe, K., and Rethans, J. J. (2009). Med. Teach. 31, 477–486. doi: 10.1080/01421590903002821 Simulation based education by Cleland, J. A. (2017). Psychologist 30, 36–40. Building Academic Staff Capacity for Using eSimulations in Professional Education for Experience Transfer by Cybulski, J., Holt, D., Segrave, S., O'Brien, D., Munro, J., Corbitt, B., et al. (2010). Sydney, NSW: Australian Learning and Teaching Council. Student and staff views of psychology OSCEs by Sheen, J., McGillivray, J., Gurtman, C. and Boyd, L. (2015). Aust. Psychol. 50, 51–59. doi: 10.1111/ap.12086 The Australian Postgraduate Psychology Education Simulation Working Group (APPESWG) recently published guidelines titled "A new reality: The role of simulated learning activities in postgraduate psychology training programs" (Paparo et al., 2021). The document was developed in the context of COVID 19-related disruption to practica within professional psychology training. As a consequence, many training providers adopted simulated training activities as a way to support course progression during the pandemic. Paparo and colleagues' stated aims were to provide comprehensive guidance for the use of simulation as a competency-based training tool and in the interests of public and student safety, both during and after COVID 19. The guidelines included nine criteria for best practice in simulated learning activities in training, for example, that activities should be competency-based, should mirror real-life practice situations and should provide opportunities for active participation and trainee reflection (see Paparo et al. for detail). The document provided helpful guidance on the use of simulated learning activities (SLA) as part of course content within an Australian professional psychology training context, however the guidelines did not cover simulated placement experiences. Considerations especially around supervision and the development of professional and ethical practice within a simulated learning environment need to be made to effectively apply the APPESWG Guidelines within a placement context. Here, we extend these guidelines for provision of simulated professional psychology placements based on our successful development and implementation of large-scale simulated placements at an Australian University (2020-current). Previously, all professional psychology placements in Australia were limited to in-vivo options, however the latest version of the Accreditation Standards for Psychology Programs (Australian Psychology Accreditation Council, 2019) now make provision for simulated learning within required placement experiences at Level 3, Professional Competencies. This extension of the Paparo et al. (2021) article provides guidelines specifically for the use of simulation with professional psychology placements, with a focus on the Australian context

Governance, regulation and financial market instability: the implications for policy

Just as the 1929 Stock Market Crash discredited Classical economic theory and policy and opened the way for Keynesianism, a consequence of the collapse of confidence in financial markets and the banking system—and the effect that this has had on the global macro economy—is currently discrediting the ‘conventional wisdom’ of neo-liberalism. This paper argues that at the heart of the crisis is a breakdown in governance that has its roots in the co-evolution of political and economic developments and of economic theory and policy since the 1929 Stock Market Crash and the Great Depression that followed. However, while many are looking back to the Great Depression and to the theories and policies that seemed to contribute to recovery during the first part of the twentieth century, we argue that the current context is different from the earlier one; and there are more recent events that may provide better insight into the causes and contributing factors giving rise to the present crisis and to the implications for theory and policy that follow

Cardiovascular Health in Anxiety or Mood Problems Study (CHAMPS): study protocol for a randomized controlled trial

Background: Previous psychological and pharmacological interventions have primarily focused on depression disorders in populations with cardiovascular diseases (CVDs) and the efficacy of anxiety disorder interventions is only more recently being explored. Transdiagnostic interventions address common emotional processes and the full range of anxiety and depression disorders often observed in populations with CVDs. The aim of CHAMPS is to evaluate the feasibility of a unified protocol (UP) for the transdiagnostic treatment of emotional disorders intervention in patients recently hospitalized for CVDs. The current study reports the protocol of a feasibility randomized controlled trial to inform a future trial. Methods/Design: This is a feasibility randomized, controlled trial with a single-center design. A total of 50 participants will be block-randomized to either a UP intervention or enhanced usual care. Both groups will receive standard CVD care. The UP intervention consists of 1) enhancing motivation, readiness for change, and treatment engagement; (2) psychoeducation about emotions; (3) increasing present focused emotion awareness; (4) increasing cognitive flexibility; (5) identifying and preventing patterns of emotion avoidance and maladaptive emotion-driven behaviors (EDBs, including tobacco smoking, and alcohol use); (6) increasing tolerance of emotion-related physical sensations; (7) interoceptive and situation-based emotion-focused exposure; and (8) relapse prevention strategies. Treatment duration is 12 to 18 weeks. Relevant outcomes include the standard deviation of self-rated anxiety, depression and quality of life symptoms. Other outcomes include intervention acceptability, satisfaction with care, rates of EDBs, patient adherence, physical activity, cardiac and psychiatric readmissions. Parallel to the main trial, a nonrandomized comparator cohort will be recruited comprising 150 persons scoring below the predetermined depression and anxiety severity thresholds. Discussion: CHAMPS is designed to evaluate the UP for the transdiagnostic treatment of emotional disorders targeting emotional disorder processes in a CVD population. The design will provide preliminary evidence of feasibility, attrition, and satisfaction with treatment to design a definitive trial. If the trial is feasible, it opens up the possibility for interventions to target broader emotional processes in the precarious population with CVD and emotional distress.Phillip J. Tully, Deborah A. Turnbull, John D. Horowitz, John F. Beltrame, Terina Selkow, Bernhard T. Baune, Elizabeth Markwick, Shannon Sauer-Zavala, Harald Baumeister, Suzanne Cosh and Gary A. Witter

Athlete Identity and Career Transition: Implications for Retirement Outcomes

The construct of athlete identity was initially conceptualised by Brewer and colleagues. Athlete identity was understood as an individual's level of identification with the athlete role, and the Athlete Identity Measurement Scale (AIMS) was developed for the systematic study of identity. The extant literature has shown that athlete identity influences adjustment to retirement. Over the past decade, alongside growth of cultural praxis within sport psychology, an emerging body of athlete identity research has been undertaken within an interpretative paradigm. Early narrative research demonstrated that retirement marked a rupture in the life stories and narratives of athletes. Analysis of the Australian newsprint media has demonstrated that limited identity positions are available for athletes during their careers and into retirement, with athletes positioned such that choice around both playing and retiring is constrained. An examination of retired Olympians highlighted that athletes continued to be ascribed the identity of champion athlete years into retirement, with limited alternatives

Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease: A meta-analysis

Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease patients remain unquantified. Systematic searching of Medline, Embase, SCOPUS and PsycINFO databases revealed 1025 unique citations. Aggregate generalized anxiety disorder prevalence (12 studies, N = 3485) was 10.94 per cent (95% confidence interval: 7.8-13.99) and 13.52 per cent (95% confidence interval: 8.39-18.66) employing Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria (random effects). Lifetime generalized anxiety disorder prevalence was 25.80 per cent (95% confidence interval: 20.84-30.77). In seven studies, modest correlation was evident between generalized anxiety disorder and depression, Fisher’s Z = .30 (95% confidence interval: .19-.42), suggesting that each psychiatric disorder is best conceptualized as contributing unique variance to coronary heart disease prognosis