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    Non-psychotic Outcomes in Young People at Ultra-High Risk of Developing a Psychotic Disorder: A Long-Term Follow-up Study
    Spiteri-Staines, AE ; Yung, AR ; Lin, A ; Hartmann, JA ; Amminger, P ; Mcgorry, PD ; Thompson, A ; Wood, SJ ; Nelson, B (OXFORD UNIV PRESS, 2024-02-16)
    BACKGROUND: The majority of individuals at ultra-high risk (UHR) for psychosis do not transition to a full threshold psychotic disorder. It is therefore important to understand their longer-term clinical and functional outcomes, particularly given the high prevalence of comorbid mental disorders in this population at baseline. AIMS: This study investigated the prevalence of non-psychotic disorders in the UHR population at entry and long-term follow-up and their association with functional outcomes. Persistence of UHR status was also investigated. STUDY DESIGN: The sample comprised 102 UHR young people from the Personal Assessment and Crisis Evaluation (PACE) Clinic who had not transitioned to psychosis by long-term follow-up (mean = 8.8 years, range = 6.8-12.1 years since baseline). RESULTS: Eighty-eight percent of participants at baseline were diagnosed with at least one mental disorder, the majority of which were mood disorders (78%), anxiety disorders (35%), and substance use disorders (SUDs) (18%). This pattern of disorder prevalence continued at follow-up, though prevalence was reduced, with 52% not meeting criteria for current non-psychotic mental disorder. However, 35% of participants developed a new non-psychotic mental disorder by follow-up. Presence of a continuous non-psychotic mental disorder was associated with poorer functional outcomes at follow-up. 28% of participants still met UHR criteria at follow-up. CONCLUSIONS: The study adds to the evidence base that a substantial proportion of UHR individuals who do not transition to psychosis experience persistent attenuated psychotic symptoms and persistent and incident non-psychotic disorders over the long term. Long-term treatment and re-entry into services is indicated.
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    "You can't swim well if there is a weight dragging you down": cross-sectional study of intimate partner violence, sexual assault and child abuse prevalence against Australian nurses, midwives and carers
    McLindon, E ; Diemer, K ; Kuruppu, J ; Spiteri-Staines, A ; Hegarty, K (BMC, 2022-09-12)
    BACKGROUND: Domestic and family violence (DFV), including intimate partner violence (IPV), sexual assault and child abuse are prevalent health and social issues, often precipitating contact with health services. Nurses, midwives and carers are frontline responders to women and children who have experienced violence, with some research suggesting that health professionals themselves may report a higher incidence of IPV in their personal lives compared to the community. This paper reports the largest study of DFV against health professionals to date. METHOD: An online descriptive, cross-sectional survey of 10,674 women and 772 men members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch). The primary outcome measures were 12-month and adult lifetime IPV prevalence (Composite Abuse Scale); secondary outcomes included sexual assault and child abuse (Australian Bureau of Statistics Personal Safety Survey) and prevalence of IPV perpetration (bespoke). RESULTS: Response rate was 15.2% of women/11.2% of men who were sent an invitation email, and 38.4% of women/28.3% of men who opened the email. In the last 12-months, 22.1% of women and 24.0% of men had experienced IPV, while across the adult lifetime, 45.1% of women and 35.0% of men had experienced IPV. These figures are higher than an Australian community sample. Non-partner sexual assault had been experienced by 18.6% of women and 7.1% of men, which was similar to national community sample. IPV survivors were 2-3 times more likely to have experienced physical, sexual or emotional abuse in childhood compared to those without a history of IPV (women OR 2.7, 95% CI 2.4 to 2.9; men OR 2.8, 95% CI 2.0 to 4.1). Since the age of sixteen, 11.7% of men and 1.7% of women had behaved in a way that had made a partner or ex-partner feel afraid of them. CONCLUSIONS: The high prevalence of intimate partner violence and child abuse in this group of nurses, midwives and carers suggests the need for workplace support programs. The findings support the theory that childhood adversity may be related to entering the nursing profession and has implications for the training and support of this group.
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    More present than absent: Men who use domestic violence and their fathering
    Humphreys, C ; Diemer, K ; Bornemisza, A ; Spiteri-Staines, A ; Kaspiew, R ; Horsfall, B (WILEY, 2019-05)
    Abstract An earlier article referred to the “absent presence” of the perpetrator in the lives of children and their mothers who have lived with domestic violence. It identified the ways in which the shadow of the perpetrator continued and was evidenced in the “symptoms of abuse” that both women and children experienced in spite of his absence. The current article argues that fathers who use violence are actually more present than absent in the lives of children (and women), even following separation. A mixed method approach surveyed men in Men's Behaviour Change Programs (N = 101), and interviewed women who had experienced violence (N = 50). The studies reported that the majority of men in both the quantitative men's study (80%) and the qualitative women's study (77%) had substantial contact with children. The women's interviews highlight the problematic fathering that many of their children experienced, both before and after separation. They reported very high levels of child abuse and poor attitudes to both women and children. The article concludes that the family violence and child welfare systems are poorly configured to address fathers who use violence and continue to hold substantial parenting roles, including following separation.
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    Working with women who use force: a feasibility study protocol of the Positive (+) SHIFT group work programme in Australia
    Kertesz, M ; Humphreys, C ; Larance, LY ; Vicary, D ; Spiteri-Staines, A ; Ovenden, G (BMJ PUBLISHING GROUP, 2019-05)
    INTRODUCTION: This study assesses the feasibility of the Positive Shift (+SHIFT) programme in the context of legal responses and social welfare provision in the state of Victoria, Australia.The +SHIFT programme, adapted from the Vista curriculum, is a group work and case management programme for women who use force. Building on traditional survivor support group strengths, the programme facilitates participants' engagement with viable alternatives to force while promoting healing. The study also aims to increase understanding about the characteristics and needs of women who use force in Australia. METHODS AND ANALYSIS: This feasibility study will assess the +SHIFT programme's appropriateness in addressing women's use of force in the Victorian context. Process evaluation will be undertaken to identify recruitment, retention, women's participation, barriers to implementation, the appropriateness of proposed outcome measures and other issues. The feasibility of an outcome evaluation which would employ a longitudinal mixed methods design with measures administered at preprogramme, programme completion and 3 months postprogramme time points, along with semistructured interviews with participants, programme staff and referring professionals, will also be assessed. ETHICS AND DISSEMINATION: Research ethics approval was obtained from the University of Melbourne Human Research Ethics Committee. Results of the study will be communicated to the programme providers as part of the action research process evaluation methodology. On completion, final results will be reported to programme providers and funding bodies, and published in academic journals and presented at national and international conferences.