Centre for Youth Mental Health - Research Publications

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    Lifestyle behaviours and mental health and wellbeing of tertiary students during COVID-19 lockdown in Australia: A cross-sectional study.
    Dash, S ; Bourke, M ; Parker, AG ; Dadswell, K ; Pascoe, MC (Elsevier BV, 2022-07)
    BACKGROUND: Australia experienced significant COVID-19 lockdown restrictions throughout 2020 that had an impact on mental health and disrupted health-promoting lifestyle behaviours. Lockdowns may have exacerbated existing mental health concerns among tertiary students, who experience higher levels of mental health concerns compared to the wider community. This study aimed to investigate the association between modifiable lifestyle factors and wellbeing of students at a Melbourne-based tertiary education institution during COVID-19 lockdown. METHODS: This quantitative, cross-sectional study was conducted across campuses in Melbourne and Sydney. Data was collected via online questionnaire during the 7th week of a second-wave lockdown. Descriptive statistics were calculated for demographic variables (n = 239). Linear regression models were estimated to determine multivariate associations between lifestyle variables and psychological distress. RESULTS: Participants were on average 30.98 years old (SD = 9.78), predominantly female, domestic students, undergraduate, not the first member of their family to attend university and living out of family home. Mindfulness, diet quality, sleep quality and moderate-vigorous physical activity (MVPA) were all inversely correlated with psychological distress. Unadjusted and adjusted models show that mindfulness, sleep quality, and MVPA were all independently inversely related to psychological distress. Greater mindfulness, sleep quality and engagement in MVPA were associated with lower psychological distress during COVID-19 lockdowns. LIMITATIONS: As this study is cross-sectional and we cannot rule out reverse causality. CONCLUSION: This study highlights the potential for lifestyle focused mental-health promotion delivered through tertiary education institutions to support students in times of crisis as well as more generally.
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    Validity and reliability of the Turkish version of Athlete Psychological Strain Questionnaire (APSQ)
    Lima, Y ; Deniz Öz, N ; Denerel, N ; Özkaya, Ö ; Senışık, S ; Rice, S (Turkish Journal of Sports Medicine, Turkish Sports Medicine Association, 2022-09-01)
    Objective: The aim of this study was to test the validity and reliability of the Turkish version of the Athlete Psychological Strain Questionnaire (APSQ). Material and Method: The APSQ, which consists of 10 items and 3 sub-dimensions (self-regulation difficulty, performance concerns, and externalized coping) and assesses athlete-specific psychological distress, was administered to a total of 565 elite athletes (247 females, and 318 males). Confirmatory factor analysis (CFA) was used to assess construct validity, and Cronbach alpha reliability analysis was used to determine internal consistency. Concurrent validity of the APSQ with the Depression Anxiety and Stress Scales-21 and the Kessler Psychological Stress Scale-10 was also tested. Results: Findings for construct validity were consistent with three-factor structure of the original questionnaire (RMSEA=0.05, SRMR=0.03, NFI=0.94, CFI=0.96, GFI=0.97). The Cronbach’s α coefficient of the whole scale was 0.83, and the Cronbach’s α coefficients of three sub-dimensions were 0.75, 0.69, and 0.50 separately. Conclusion: Findings demonstrate that the Turkish adaptation of the APSQ has sufficient psychometric properties for widespread use, assessing key dimensions of psychological strain experienced by elite athletes.
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    [Early Intervention for Psychosis from Past to Future: Overcoming Implementation Challenges to Maximize its Impact?]
    Malla, A ; Roy, M-A ; Abdel-Baki, A ; Conus, P ; McGorry, P (Consortium Erudit, 2021)
    Objectives The emergence of early intervention for first episode psychosis (FEP) in the 1990s represents a major advance in mental health. It was demonstrated that by providing intensive interventions tailored to the specific needs of youth at the onset of FEP, it became possible to sustainably improve their subsequent course. This model of early intervention for psychosis (EIP) is accompanied by a major revision of conceptions of psychotic disorders and a major change in philosophy of care. The purpose of this article is to provide a historical perspective on the development of EIP, to discuss the challenges associated with its implementation, and to offer possible solutions. Methods Experts consensus identifying the most salient challenges in implementing Early intervention for psychosis, and proposing the most feasible solutions, based on their assessment of the literature to address them. Results To optimize the implementation and efficiency of EIP programs, 7 avenues were identified: 1) Better targeting of hard-to-reach populations and systematizing the admission of all FEP patients in EIP programs. 2) Reducing the duration of untreated psychosis should be a major goal of EIP programs, requiring early detection efforts through public awareness, training of front-line professionals, and improving treatment access processes and delays. 3) Measures to maintain patient engagement in a follow-up should be implemented systematically. 4) Family involvement should be more actively supported by teams throughout follow-up, including strategies to promote patient acceptance of their involvement. 5) Future research will provide a better understanding of how to modulate the duration and intensity of EIP follow-up according to patient profiles, in particular in order to maintain the results achieved during PPEP over the longer term. 6) The modalities for managing at-risk mental states remain to be clarified, both in terms of the approaches to be offered to them and the health care structure that would be most appropriate to accommodate them. 7) The implementation of EIP programs must be continued, particularly in the French-speaking world, which is at very different stages from one country to another and even within each country. Conclusion EIP improve the outcomes of youth with FEP in terms of recovery, mortality and suicide. Solutions to challenges encountered in their widespread implementation must be operationalized to ensure that this care is accessible to the greatest number of people in a timely manner to maximize its impact at the population level.
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    [Strength in Numbers: Launching a National and International French-Speaking Movement for the Implementation of Early Intervention Services].
    Bertulies-Esposito, B ; Abdel-Baki, A ; Conus, P ; Krebs, M-O (Consortium Erudit, 2021)
    Objective To describe the implementation of early intervention for psychosis in 3 French-speaking countries, the challenges encountered and potential facilitators for successful implementation. Methods Narrative synthesis of the scientific and grey literature on early intervention for psychosis programs implementation in the French-speaking world. Results Compared to other countries (Australia, United Kingdom, etc.), early intervention program implementation in the French-speaking world has been delayed and faces various challenges, making its widespread implementation still very heterogeneous. Although a large proportion of the population has access to early intervention services (EIS) in Quebec (Canada), adherence with certain essential components of the model still poses challenges. However, various facilitators, including government involvement through the publication of a provincial framework standardizing practices, dedicated funding, and clinical support for program implementation and continuous improvement through the National Centre of Excellence in Mental Health (a provincial organization) and a provincial community of practice, the Association québécoise des programmes pour premiers épisodes psychotiques (AQPPEP), which offers mentoring and continuing education, have been identified. In France, although the implementation has been more heterogenous, several centers already offer EIS, and there is growing interest in this model, as expressed by several teams, giving hope for the implementation of a network of EIS throughout the country. Since 2007, the "Réseau transition" has been organizing scientific meetings, specialized training, validation of tools and is working on publishing a reference tool adapted to the French system to standardize EIS. In French-speaking Switzerland, although programs were implemented relatively early (in 2000 in Geneva, and in 2004 in Lausanne), they remained associated to individual initiatives and local choices. This is largely due to the complete autonomy of each of the 26 cantons in the organization of the healthcare system and the absence of a national mental health policy. However, a French-speaking Swiss group has been set up in 2020, to support the implementation of 5 programs in 5 cantons. Several specificities of the organization of mental health care in each country may have an impact on implementation. These include the relative autonomy of different catchment areas, and the separation of child and adolescent psychiatry from adult services. Furthermore, it seems that poor involvement in quality assurance activities and the lack of monitoring of adherence to expert recommendations on essential components of the EIS model may impact program implementation. Conclusion In addition to continuing national efforts, a francophone branch of the International Early Psychosis Association (IEPA) founded by Swiss, French and Quebec leaders to join forces on a larger scale seeks to promote networking as well as tool and expertise sharing through an annual international francophone conference focused on early intervention in first-episode psychosis.
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    [Early Detection and Intervention for Psychosis: Why and How?]
    Bertulies-Esposito, B ; Sicotte, R ; Iyer, SN ; Delfosse, C ; Girard, N ; Nolin, M ; Villeneuve, M ; Conus, P ; Abdel-Baki, A (Consortium Erudit, 2021)
    Objectives This article aims to synthesize the critical stages in the development of early detection and intervention services (EIS) for psychosis over the past 30 years, and to review key literature on the essential components and effectiveness of these programs. Method We conducted a narrative review of the literature on the international development of EIS leading to its endorsement as a service delivery model for young people with first-episode psychosis (FEP). We also reviewed various international and Canadian guidelines to identify consensus about the essential components of EIS for psychosis and their effectiveness. Challenges to the implementation of these different essential components are presented, along with practical solutions to addressing them. A particular emphasis is placed on implementing EIS in the Quebec context. Results Based on a model developed in the early 1990s, EIS for psychosis have now been disseminated worldwide and are deployed on a large scale in some regions, such as the United Kingdom and Quebec. The model's gradual expansion has been facilitated by efforts to identify its main objectives and the components essential to achieve them, and by several studies demonstrating its effectiveness. Along with an important philosophical shift to optimism and hope, EIS have typically focused on the twin aims of reducing treatment delay (or the duration of untreated psychosis) and enhancing engagement in specialized, phase-specific, developmentally appropriate treatment. A meta-analysis (published in 2018) demonstrated the superiority of EIS for psychosis compared to standard treatment on several outcomes including hospitalizations, relapse of symptoms, treatment discontinuation, and vocational and social functioning. Based on these studies and expert consensus, many jurisdictions around the world have developed guidelines to ensure compliance with essential components that are associated with the effectiveness of EIS, while accounting for their contextual realities. The components that have been prioritized include outreach to enable early identification and referral; rapid access to care and youth-friendly services; a range of biopsychosocial interventions (pharmacotherapy, cognitive behavioral therapy, psychoeducation, family interventions, integrated substance use interventions, employment and educational support); a shared-decision making approach; and the intensive case management approach adapted to FEP, which are all delivered by an interdisciplinary team. There is also increasing acknowledgement of the value of continuous evaluation that informs treatment decision-making and quality improvement. Conclusion EIS for psychosis have developed gradually and research has demonstrated its effectiveness. Disseminating the model in ways that ensure fidelity to its core values and the implementation of its essential components is needed to ensure effectiveness; and instill hope for recovery and improve the quality of lives of young people with psychosis and their families.
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    Parent Education for Responding to and Supporting Youth with Suicidal Thoughts (PERSYST): An Evaluation of an Online Gatekeeper Training Program with Australian Parents
    McKay, S ; Byrne, SJ ; Clarke, A ; Lamblin, M ; Veresova, M ; Robinson, J (MDPI, 2022-05-01)
    The gatekeeper training of parents is a promising approach for suicide prevention in young people, but little research has addressed the effectiveness of such training, especially using online delivery. This study aimed to evaluate the efficacy and acceptability of the delivery of an online suicide prevention training program, LivingWorks Start, to improve the capacity of parents to support young people at risk of suicide. The participants were 127 parents of young people aged 12-25 who completed the LivingWorks Start training and consented to participate in the evaluation. The participants completed online surveys before, after, and 3 months after training. The participants showed increases in perceived self-efficacy and formal help-seeking intentions, and reductions in suicide stigma, although stigma returned to the baseline three months post-training. Suicide literacy also increased, but only at the three-month follow-up. Most parents found the training acceptable, and did not find it upsetting. Prior mental health, suicide-related experiences, and pre-participation vulnerability were not predictive of finding the training distressing. Overall, the findings show that online gatekeeper training for parents can be beneficial, and is rarely associated with distress.
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    An evaluation of the psychometric properties of the Fear of COVID-19 Scale in a sample of help-seeking men
    Rice, SM ; Trail, K ; Walton, CC ; Kealy, D ; Seidler, ZE ; Wilson, MJ ; Oliffe, JL ; Ogrodniczuk, JS (Komitet Redakcyjno - Wydawniczy Polskiego Towarzystwa Psychiatrycznego, 2022-03-01)
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    Association between peripheral redox markers, anxiety and amygdala volumes during adolescence: gender differences
    Schilliger, Z ; Do, KQ ; Conus, P ; Piguet, C ; Merglen, A ; Dwir, D ; Klauser, P (Elsevier BV, 2022)