Melbourne Institute of Applied Economic and Social Research - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 15
-
ItemThe persistence of welfare stigma: Does the passing of time and subsequent employment moderate the negative perceptions associated with unemployment benefit receipt?(Wiley, 2019-09-01)People receiving welfare payments are stigmatized. However, previous studies of welfare recipient stereotypes have not examined whether the stigma endures after payments are no longer received and have rarely considered the stigma associated with specific categories of welfare payments. We examined whether welfare stigma endures in three experiments (total N = 873) focused on one category of welfare recipient, people receiving government income support due to their unemployment. To test if this stigmatized identity marked or scarred how people are perceived, we compared evaluations of currently unemployed benefit recipients to currently employed people who either previously received this benefit or who had no stated history of benefit receipt. Across the three experiments, we found that current recipients of unemployment benefits were evaluated as much less conscientious, less human, and poorer workers, but as somewhat more extraverted than currently employed individuals irrespective of their welfare history. Moreover, we found that currently employed individuals were evaluated similarly, regardless of whether they had a prior history of benefit receipt, and the recency of this prior benefit experience. This pattern of results suggests that receiving unemployment benefits does not scar how a person is perceived by others, but only temporarily marks how they are perceived. These findings suggest that welfare stigma may create an evaluative barrier to returning to work, but that if this barrier can be overcome there are no negative evaluations of former recipients’ character. Overall, community members seem accepting of prior benefit receipt once a person returns to work.
-
ItemShortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4(Wiley, 2019-01-01)Background: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. Methods: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between one and eight items, including and excluding the ninth item. The final short form was selected based on prespecified validity, reliability, and diagnostic accuracy criteria. Results: A four-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach's alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). Conclusion: The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been used to shorten patient-reported outcome measures based on objective, prespecified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.
-
ItemAmphetamine use in the fourth decade of life: Social profiles from a population-based Australian cohort(WILEY, 2018-09)INTRODUCTION AND AIMS: To estimate the prevalence and frequency of amphetamine use in a cohort of Australians aged in their mid-30s. DESIGN AND METHODS: Cross-sectional analysis of wave 10 data collected in 2014 from the Victorian Adolescent Health Cohort Study: a sample of 1435 persons originally selected in a stratified, random community survey of secondary school students from the state of Victoria that commenced in 1992. Weighted multinomial regression models were used to evaluate the social, health and other substance-use correlates of lifetime and current (12-month) amphetamine use and current frequency of use. RESULTS: Lifetime amphetamine use was reported by 23.2% (95% confidence interval 21.0-25.5%) of respondents, and 6.5% (95% confidence interval 5.2-7.8%) reported current (12-month) use. A quarter (26%) of those currently using amphetamines, 1.7% (95% confidence interval 1.0-2.4%) of all respondents, reported frequent (at least weekly) use. Men reported greater amphetamine use than women. Current amphetamine use was associated with disrupted family circumstances, socioeconomic adversity, polydrug use and high levels of drug use within the social and familial environment. Frequent use was associated with greater likelihood of multiple adversity, unemployment, anxiety disorders and use of mental health services. DISCUSSION AND CONCLUSIONS: The current results show that lifetime, current and frequent amphetamine use was common amongst adults in the fourth decade of life in this cohort, and associated with the experience of social disadvantage, poor mental health and living in a social context in which drug use is the norm.
-
ItemWestern diet is associated with a smaller hippocampus: a longitudinal investigation(BMC, 2015-09-08)BACKGROUND: Recent meta-analyses confirm a relationship between diet quality and both depression and cognitive health in adults. While the biological pathways that underpin these relationships are likely multitudinous, extensive evidence from animal studies points to the involvement of the hippocampus. The aim of this study was to examine the association between dietary patterns and hippocampal volume in humans, and to assess whether diet was associated with differential rates of hippocampal atrophy over time. METHODS: Data were drawn from the Personality and Total Health Through Life Study and focused on a subsample of the cohort (n = 255) who were aged 60-64 years at baseline in 2001, completed a food frequency questionnaire, and underwent two magnetic resonance imaging scans approximately 4 years apart. Longitudinal generalized estimating equation linear regression models were used to assess the association between dietary factors and left and right hippocampal volumes over time. RESULTS: Every one standard deviation increase in healthy "prudent" dietary pattern was associated with a 45.7 mm(3) (standard error 22.9 mm(3)) larger left hippocampal volume, while higher consumption of an unhealthy "Western" dietary pattern was (independently) associated with a 52.6 mm(3) (SE 26.6 mm(3)) smaller left hippocampal volume. These relationships were independent of covariates including age, gender, education, labour-force status, depressive symptoms and medication, physical activity, smoking, hypertension and diabetes. While hippocampal volume declined over time, there was no evidence that dietary patterns influenced this decline. No relationships were observed between dietary patterns and right hippocampal volume. CONCLUSIONS: Lower intakes of nutrient-dense foods and higher intakes of unhealthy foods are each independently associated with smaller left hippocampal volume. To our knowledge, this is the first human study to demonstrate associations between diet and hippocampal volume concordant with data previously observed in animal models.
-
ItemLongitudinal cohort study describing persistent frequent attenders in Australian primary healthcare(BMJ PUBLISHING GROUP, 2015)OBJECTIVES: To describe patterns of frequent attendance in Australian primary care, and identify the prospective risk factors for persistent frequent attendance. DESIGN, SETTING AND PARTICIPANTS: This study draws on data from the Personality and Total Health (PATH) Through Life Project, a representative community cohort study of residents from the Canberra region of Australia. Participants were assessed on 3 occasions over 8 years. The survey assessed respondents' experience of chronic physical conditions, self-reported health, symptoms of common mental disorders, personality, life events, sociodemographic characteristics and self-reported medication use. A balanced sample was used in analysis, comprising 1734 respondents with 3 waves of data. The survey data for each respondent were individually linked to their administrative health service use data which were used to generate an objective measure of general practitioner (GP) consultations in the 12 months surrounding their interview date. MAIN OUTCOME MEASURES: Respondents in the (approximate) highest decile of attenders on number of GP consultations over a 12-month period at each time point were defined as frequent attenders (FAs). RESULTS: Baseline FAs (8.4%) were responsible for 33.4% of baseline consultations, while persistent FAs (3.6%) for 15.5% of all consultations over the 3 occasions. While there was considerable movement between FA status over time, consistency was greater than expected by chance alone. While there were many factors that differentiated non-FAs from FAs in general, persistent frequent attendance was specifically associated with gender, baseline reports of depression, self-reported physical conditions and disability, and medication use. CONCLUSIONS: The degree of persistence in GP consultations was limited. The findings of this study contribute to our understanding of the risk factors that predict subsequent persistent frequent attendance in primary care. However, further detailed investigation of longitudinal patterns of frequent attendance and consideration of time-varying determinants of frequent attendance is required.
-
ItemPatterns of Welfare Attitudes in the Australian Population(PUBLIC LIBRARY SCIENCE, 2015-11-10)The study of community attitudes toward welfare and welfare recipients is an area of increasing interest. This is not only because negative attitudes can lead to stigmatization and discrimination, but because of the relevance of social attitudes to policy decisions. We quantify the attitudes toward welfare in the Australian population using attitude data from a nationally representative survey (N = 3243). Although there was broad support for the social welfare system, negative attitudes are held toward those who receive welfare benefits. Using canonical correlation analysis we identify multivariate associations between welfare attitudes and respondent demographic characteristics. A primary attitudinal dimension of welfare positivity was found amongst those with higher levels of education, life instability, and personal exposure to the welfare system. Other patterns of negative welfare attitudes appeared to be motivated by beliefs that the respondent's personal circumstances indicate their deservingness. Moreover, a previously unidentified and unconsidered subset of respondents was identified. This group had positive attitudes toward receiving government benefits despite having no recent experience of welfare. They did, however, possess many of the characteristics that frequently lead to welfare receipt. These results provide insights into not only how attitudinal patterns segment across the population, but are of relevance to policy makers considering how to align welfare reform with community attitudes.
-
ItemThe Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration(PUBLIC LIBRARY SCIENCE, 2015-11-05)BACKGROUND: Changes in criteria and differences in populations studied and methodology have produced a wide range of prevalence estimates for mild cognitive impairment (MCI). METHODS: Uniform criteria were applied to harmonized data from 11 studies from USA, Europe, Asia and Australia, and MCI prevalence estimates determined using three separate definitions of cognitive impairment. RESULTS: The published range of MCI prevalence estimates was 5.0%-36.7%. This was reduced with all cognitive impairment definitions: performance in the bottom 6.681% (3.2%-10.8%); Clinical Dementia Rating of 0.5 (1.8%-14.9%); Mini-Mental State Examination score of 24-27 (2.1%-20.7%). Prevalences using the first definition were 5.9% overall, and increased with age (P < .001) but were unaffected by sex or the main races/ethnicities investigated (Whites and Chinese). Not completing high school increased the likelihood of MCI (P ≤ .01). CONCLUSION: Applying uniform criteria to harmonized data greatly reduced the variation in MCI prevalence internationally.
-
ItemWithin-individual analysis of pain and sickness absence among employees from low and high occupational classes: a record linkage study(BMJ Journals, 2019-06-01)Objectives Pain is linked to an increased risk of sickness absence (SA); however, the extent to which unmeasured time-invariant differences explain this association is yet unknown. Therefore, we determined the within-individual associations between pain and short-term (in the survey year) and long-term (2 years following the survey years) SA risk in high and low occupational classes while controlling for the potential bias due to unobservable time-invariant characteristics. Methods The Helsinki Health Study data consisting of midlife public sector employees with mailed surveys from up to four time points, and SA record linkage were used (3983 persons). The within-individual estimates were calculated using hybrid negative binomial regression models. Results Acute/subacute pain was associated with a 13% increase in the rate of short-term SA days (incidence rate ratio 1.13 [95% CI 1.01 to 1.27]), while the association was somewhat stronger for chronic pain (1.32 [1.19–1.47]). For the employees in the low occupational class, these associations were robust (1.29 [1.10–1.50] for acute/subacute and 1.43 [1.23–1.66] for chronic pain), whereas only chronic pain was associated with SA among those in the high occupational class (1.25 [1.08–1.46]). Chronic pain was also associated with SA days in the long term without occupational class differences. Similar results were obtained for multisite pain (pain in several locations). Conclusions These results indicate that particularly chronic and multisite pain have a within-individual link to SA but ignoring unobservable differences between those reporting pain and those not might yield overstated effect sizes. Pain might have a different relation to SA in low and high occupational classes.
-
ItemThe association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies(Elsevier, 2019-12-01)Background: There has long been debate about the extent to which mental disorders contribute to suicide. We aimed to examine the evidence on the contribution of mental disorders to suicide among record linkage studies. Methods: We performed a systematic search using eight major health databases for English-language studies published between 1 January 2000 and 11 June 2018 that linked collected data on mental disorders and suicide. We then conducted a meta-analysis to assess risk of suicide conferred by mental disorders. Results: Our search identified 20 articles representing 13 unique studies. The pooled rate ratio (RR) was 13.2 (95% CI 8.6–20.3) for psychotic disorders, 12.3 (95% CI 8.9–17.1) for mood disorders, 8.1 (95% CI 4.6–14.2) for personality disorders, 4.4 (95% CI 2.9–6.8) for substance use disorders, and 4.1 (95% CI 2.4–6.9) for anxiety disorders in the general population. The overall pooled RR for these mental disorders was 7.5 (95% CI 6.6–8.6). The population attributable risk of mental disorders was up to 21%. Limitations: The overall heterogeneity between studies was very high. Conclusions: Our findings underline the important role of mental disorders in suicide. This suggests that ongoing efforts are required to improve access to and quality of mental health care to prevent suicide by people with mental disorders.
-
ItemPsychosocial Job Stressors and Mental Health The Potential Moderating Role of Emotion Regulation(LIPPINCOTT WILLIAMS & WILKINS, 2018-10)OBJECTIVE: This study examines whether emotion regulation moderates the association between psychosocial job stressors and psychological distress. METHODS: We used data from the Work and Wellbeing Survey of 1044 Australian working adults. An adjusted linear regression model was used to estimate the moderating effect of emotion regulation. RESULTS: The impact of low fairness and low control at work on distress was stronger in individuals with low (rather than high) cognitive reappraisal [β = 2.42, 95% confidence interval (95% CI) = 0.07 to 4.76; β = 2.58, 95% CI = 0.04 to 5.12, respectively], whereas the impact of high demands on distress was stronger in those with high (rather than low) expressive suppression (β = 2.94, 95% CI = 0.78 to 5.10). CONCLUSION: Individual differences in emotion regulation in response to adverse job conditions should be considered in the management of workplace mental health.