Melbourne School of Psychological Sciences - Research Publications

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    Examining the facets of mindful engagement and mind wandering in nature
    Macaulay, R ; Johnson, K ; Lee, K ; Williams, K (Elsevier BV, 2024-03)
    Mindfulness and mind wandering may both enhance the psychological outcomes of nature experiences. Both states are multi-faceted, with mindfulness involving specific components such as decentering, body awareness, and nonjudgment, and mind wandering involving intentional and spontaneous mind wandering. These facets may differentially predict psychological outcomes of nature experiences, however these associations have not been tested. In this study we examined facets of mindfulness and mind wandering in nature and tested their associations with outcomes of psychological restoration and nature connection. We also tested the effects of situational factors on these engagement facets in nature. We conducted an experiment in which participants were instructed on how to engage with nature during a 20min experience in nearby nature and completed online surveys before and after the outdoor experience. Participants were allocated into one of four groups, each given different engagement instructions. We used measures of state mindfulness that assessed three facets – decentering, nonjudgment, and body awareness – and measures of mind wandering that assessed two facets – mindlessness, and deliberate mind wandering. Regression analyses revealed associations between these facets and outcomes of the nature experience; decentering and deliberate mind wandering were associated with positive outcomes, including stronger nature connection and positive affect, and nonjudgment was associated with higher negative affect. Further analyses revealed perceived restorativeness and other situational factors such as affective state influenced engagement during the nature experience. These results demonstrate the value of deconstructing mindfulness and mind wandering in nature to explore facets that have beneficial or adverse effects on psychological outcomes. We conclude with practical directions for nature-based engagement interventions that can target the beneficial components of these practices in different contexts.
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    Plasma neurofilament light in behavioural variant frontotemporal dementia compared to mood and psychotic disorders
    Eratne, D ; Kang, M ; Malpas, C ; Simpson-Yap, S ; Lewis, C ; Dang, C ; Grewal, J ; Coe, A ; Dobson, H ; Keem, M ; Chiu, W-H ; Kalincik, T ; Ooi, S ; Darby, D ; Brodtmann, A ; Hansson, O ; Janelidze, S ; Blennow, K ; Zetterberg, H ; Walker, A ; Dean, O ; Berk, M ; Wannan, C ; Pantelis, C ; Loi, SM ; Walterfang, M ; Berkovic, SF ; Santillo, AF ; Velakoulis, D (SAGE PUBLICATIONS LTD, 2024-01)
    OBJECTIVE: Blood biomarkers of neuronal injury such as neurofilament light (NfL) show promise to improve diagnosis of neurodegenerative disorders and distinguish neurodegenerative from primary psychiatric disorders (PPD). This study investigated the diagnostic utility of plasma NfL to differentiate behavioural variant frontotemporal dementia (bvFTD, a neurodegenerative disorder commonly misdiagnosed initially as PPD), from PPD, and performance of large normative/reference data sets and models. METHODS: Plasma NfL was analysed in major depressive disorder (MDD, n = 42), bipolar affective disorder (BPAD, n = 121), treatment-resistant schizophrenia (TRS, n = 82), bvFTD (n = 22), and compared to the reference cohort (Control Group 2, n = 1926, using GAMLSS modelling), and age-matched controls (Control Group 1, n = 96, using general linear models). RESULTS: Large differences were seen between bvFTD (mean NfL 34.9 pg/mL) and all PPDs and controls (all < 11 pg/mL). NfL distinguished bvFTD from PPD with high accuracy, sensitivity (86%), and specificity (88%). GAMLSS models using reference Control Group 2 facilitated precision interpretation of individual levels, while performing equally to or outperforming models using local controls. Slightly higher NfL levels were found in BPAD, compared to controls and TRS. CONCLUSIONS: This study adds further evidence on the diagnostic utility of NfL to distinguish bvFTD from PPD of high clinical relevance to a bvFTD differential diagnosis, and includes the largest cohort of BPAD to date. Using large reference cohorts, GAMLSS modelling and the interactive Internet-based application we developed, may have important implications for future research and clinical translation. Studies are underway investigating utility of plasma NfL in diverse neurodegenerative and primary psychiatric conditions in real-world clinical settings.
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    Methodological considerations for observational studies of treatment effectiveness in neurology: a clinician's guide
    Kalincik, T ; Roos, I ; Sharmin, S ; Malpas, CB (BMJ PUBLISHING GROUP, 2023-10-27)
    Data from cohorts, registries, randomised trials, electronic medical records and administrative claims databases have increasingly been used to inform the use of therapies for neurological diseases. While novel sophisticated methods are enabling us to use existing data to guide treatment decisions, the complexity of statistical methodology is making appraisal of clinical evidence increasingly demanding. In this narrative review, we provide a brief overview of the most commonly used methods for evaluation of treatment effectiveness in neurology. This primer discusses complementarity of randomised and non-randomised study designs, sources of observational data, different forms of bias and the appropriate mitigation strategies, statistical significance, Bayesian approaches and provides an overview of multivariable regression models, propensity score-based models, causal inference, mediation analysis and Mendelian randomisation.
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    Method-Specific Suicide Mortality in the United States in the 21st Century
    Dhungel, B ; Shand, F ; Nguyen, P ; Wang, Y ; Fujita-Imazu, S ; Soe, JKM ; Xie, J ; Wang, X ; Li, J ; Gilmour, S (AMER COLL PHYSICIANS, 2024-01)
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    Elucidating the Visual Snow Spectrum: A Latent Class Analysis Study
    Thompson, AC ; Goodbourn, PT ; Forte, JD ; Trojano, L (HINDAWI LTD, 2024-01-19)
    OBJECTIVE: People with visual snow syndrome (VSS) experience a range of perceptual phenomena, in addition to visual snow (VS; flickering pinpricks of light throughout the visual field). We investigated the patterns of perceptual phenomena associated with VSS in a large sample of people without prior knowledge of VSS or its associated symptoms. Methods and Measures. Two thousand participants completed a screening questionnaire assessing the frequency and severity of perceptual phenomena associated with VSS. We used latent class analysis (LCA), a clustering technique which identifies qualitatively different subgroups within a given population, to investigate whether the presence (or absence) of VS impacted class structure. RESULTS: Of 1,846 participants included for analysis, 41.92% experienced VS some of the time, including 4.49% who had VSS without prior knowledge. The mean number of perceptual phenomena experienced was 2.03. Optimal four-class LCA solutions did not substantially differ whether VS was included in the model; instead, classes differed in the frequency and total number of symptoms experienced. Discussion. Our results suggest that the perceptual phenomena associated with VSS are likely to be common in the general population and do not necessarily indicate an underlying pathology. We also showed that visual snow itself does not explain the presence of other perceptual phenomena.
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    A deep learning quantification of patient specificity as a predictor of session attendance and treatment response to internet-enabled cognitive behavioural therapy for common mental health disorders.
    Hitchcock, C ; Funk, J ; Cummins, R ; Patel, SD ; Catarino, A ; Takano, K ; Dalgleish, T ; Ewbank, M (Elsevier BV, 2024-04-01)
    BACKGROUND: Increasing an individual's ability to focus on concrete, specific detail, thus reducing the tendency toward overly broad, decontextualised generalisations about the self and world, is a target within cognitive behavioural therapy (CBT). However, empirical investigation of the impact of within-treatment specificity on treatment outcomes is scarce. We evaluated whether the specificity of patient dialogue predicted a) end-of-treatment symptoms and b) session completion for CBT for common mental health issues. METHODS: This preregistered (https://osf.io/agr4t) study trained a deep learning model to score the specificity of patient dialogue in transcripts from 353,614 internet-enabled CBT sessions for common mental health disorders, delivered on behalf of UK NHS services. Data were from obtained from 65,030 participants (n = 47,308 female, n = 241 unstated) aged 18-94 years (M = 34.69, SD = 12.35). Depressive disorders were the most common (39.1 %) primary diagnosis. Primary outcome was end-of-treatment score on the Patient Health Questionnaire-9 (PHQ-9). Secondary outcome was number of sessions attended. RESULTS: Linear mixed-effects models demonstrated that increased patient specificity significantly predicted lower post-treatment symptoms on the PHQ-9, although the size and direction of the effect varied depending on the type of therapeutic activity being completed. Effect sizes were consistently small. Higher patient specificity was associated with completing a greater number of sessions. LIMITATIONS: We are unable to infer causation from our data. CONCLUSIONS: Although effect sizes were small, an effect of specificity was observed across common mental health disorders. Further studies are needed to explore whether encouraging patient specificity during CBT may provide an enhancement of treatment attendance and treatment effects.
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    Exploring grandparents? receptivity to and preferences for a grandchild nutrition-focused intervention: A qualitative study
    Robinson, A ; Jongenelis, MI ; Morley, B ; Talati, Z (ELSEVIER SCIENCE INC, 2023-02)
    OBJECTIVE: Interventions promoting healthy eating in children typically overlook the critical role of grandparent caregivers. Utilising a co-design approach, this study (i) assessed the receptiveness of grandparents to a nutrition-focused resource aimed at promoting healthy eating in their grandchildren and (ii) explored grandparents' preferences for resource delivery and dissemination. METHODS: Seventy-nine grandparents (58% female; mean age=69.37 years) who were secondary carers to a grandchild aged 3-12 years participated in one of 10 focus groups. Focus group transcripts were imported into NVivo for coding and semantic thematic analysis. RESULTS: The vast majority of focus groups (n=9) were receptive to receiving a nutrition-focused resource. Participants indicated that such a resource should contain strategies that help grandparents promote healthy eating in their grandchildren rather than outline what grandchildren should be fed. A range of delivery (pamphlets, seminars and fridge magnets) and dissemination (online, email) methods were suggested. CONCLUSIONS: A nutrition resource that equips grandparents with the strategies they need to promote healthy eating in their grandchildren would likely be welcomed. IMPLICATIONS FOR PUBLIC HEALTH: Results provide program developers with the preliminary information required to tailor childhood lifestyle interventions to the needs of grandparents, thus helping increase acceptability and uptake.
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    Examination of bidirectional relationships between fear of negative evaluation and weight/shape concerns over 3 years: A longitudinal cohort study of Australian adolescents
    Trompeter, N ; Austen, E ; Bussey, K ; Reilly, EE ; Cunningham, ML ; Mond, J ; Lonergan, A ; Tame, J ; Mitchison, D (Wiley, 2023-03)
    OBJECTIVE: Adolescents commonly experience both fear of negative evaluation and weight/shape concerns. However, evidence concerning the prospective associations between these constructs during adolescence is limited. The current study examined the bidirectional relationships between fear of negative evaluation and weight/shape concerns over a 3-year period in adolescents. METHOD: Australian high school students (n = 2073; 55% girls) completed self-report measures at three timepoints, each 1 year apart. RESULTS: Findings showed a bidirectional relationship, whereby increases in fear of negative evaluation predicted exacerbated weight/shape concerns, and vice versa. Results point towards a vicious maintenance cycle between fear of negative evaluation and weight/shape concerns. DISCUSSION: Findings from the current study highlight the importance of considering both fear of negative evaluation and weight/shape concerns in the development of health promotion and prevention programs designed to reduce the occurrence and adverse effects of body dissatisfaction or improve general mental health. PUBLIC SIGNIFICANCE: Many adolescents experience some level of fear of negative evaluation (i.e., worry about being judged by others) and worry about their weight and/or shape. This study examined the prospective relationship between both constructs. Findings showed a bidirectional relationship, whereby higher fear of negative evaluation predicted increased weight/shape concerns, and vice versa. Programs designed to reduce body dissatisfaction might be improved by targeting both fear of negative evaluation and weight/shape concerns.
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    Monthly computerized at‐home assessments to detect cognitive change in preclinical Alzheimer’s disease
    Jutten, RJ ; Amariglio, RE ; Properzi, MJ ; Buckley, RF ; Maruff, PT ; Stark, CE ; Yassa, MA ; Johnson, KA ; Sperling, RA ; Rentz, DM ; Papp, KV (Wiley, 2021-12)
    Abstract Background Alongside the increased focus on detecting Alzheimer’s disease (AD) pathology in the preclinical stage, there is a need to more rapidly track AD‐related cognitive changes that may emerge during this stage. Computerized cognitive testing has the potential to achieve this by enabling more frequent, remote, unsupervised assessments. Here, we aimed to investigate whether monthly at‐home assessments of a modified version of the Behavioural Pattern Separation Task‐Object Version (BPSO) could detect cognitive change in cognitively unimpaired (CU) individuals with and without abnormal AD biomarkers. Method N=110 CU participants (age=77.1±4.9, 61% female, MMSE 29±1.3) from the Harvard Aging Brain Study completed the BPSO monthly at‐home on an iPad as part of the Cogstate C3 battery for up to one year (6.3±3.9 months follow‐up). All participants underwent PIB‐PET imaging (1.25±1.05 years before at‐home baseline) and a subset (n=82) underwent Flortaucipir PET (0.56±0.4 years before at‐home baseline). Primary outcome of the BPSO is a metric reflecting the ability to correctly discriminate between stimuli that are similar but not identical to previously learned targets (score range 0‐1, higher scores reflecting better performance). Linear mixed models were used to characterize BPSO performance over months (including both linear and quadratic time terms to investigate nonlinear change), and to examine associations with amyloid (dichotomous) and medial‐temporal tau deposition (continuous) while adjusting for age, sex, education and their interactions with time. Result Overall, individuals’ BPSO performance improved over months, as shown by a significant quadratic effect of time (β=‐.002,p<.001) with a plateauing learning curve (Figure 1). On average, amyloid‐positive individuals (n=29) showed slightly worse BPSO performance (β=‐.06,p=.03) than amyloid‐negative individuals, but similar trajectories over time. However, the baseline amyloid effect was attenuated when limiting the sample to those with both amyloid and tau imaging. Less improvement over the year was associated with greater tau burden in the entorhinal cortex (Time*tau β=‐0.02,p=.019) (Figure 2). Conclusion We show that subtle alterations in pattern separation performance over repeated exposure in CU individuals are associated with tau deposition in the medial‐temporal lobe. This implies that unsupervised computerized testing using monthly learning paradigms may be an efficient way to early detect cognitive change associated with preclinical AD.
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    Association of neighborhood‐level socioeconomic advantage with cognition and dementia risk factors in an Australian cohort
    Cavuoto, MG ; Rowsthorn, E ; Lavale, A ; Yassi, N ; Maruff, PT ; Buckley, RF ; Lim, YY ; Pase, MP (Wiley, 2021-12)
    Abstract Background Residing in areas of low socioeconomic advantage is associated with increased risk of dementia1 and associated brain pathology2,3. Given the long and insidious course of dementia pathologies, it is critical to establish the effect of ‘exposomic’ risk factors in midlife and to understand which groups of people are particularly vulnerable. Therefore, the objective of this study was to examine whether cognitive performance or dementia risk factors differed according to neighborhood‐level socioeconomic advantage in cognitively normal middle‐aged people. Methods Our sample comprised 4798 participants from the Healthy Brain Project, an online cohort of community‐dwelling Australians aged 40‐70 years. Socioeconomic advantage was computed by matching participants’ residential address to the Australian Bureau of Statistics’ Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD), assigning each participant a decile score (10 being the most advantaged). Scores were related to dementia risk estimated using the CAIDE dementia risk score and cognitive performance measured with the Cogstate Brief Battery (CBB) in linear regression models. Results Of the 4798 participants (mean age±SD 56±7 years, 26% male), 2762 (58%) were classified as living within an area of high neighbourhood socioeconomic advantage (IRSAD scores ≥ 8th decile), 1296 resided in rural or regional areas (27%), and 984 identified as “non‐European” (21%). Each decile unit increase in neighborhood socioeconomic advantage was associated with a lower CAIDE dementia risk score (β±SE= ‐0.088±0.024, p <0.001), following adjustments for race and rurality, and with better memory performance (β±SE= 0.084±0.024, p <0.001), following adjustments for age, sex, race, education, and rurality. An interaction was observed with differences in memory performance between levels of neighborhood advantage (comparing scores above and below the 8th decile) being larger at older ages and in people with higher dementia risk scores (Figure 1). There was no association between neighborhood‐level advantage and attention. Conclusions In a middle‐aged Australian cohort, higher neighborhood‐level socioeconomic advantage was associated with superior memory and lower dementia risk scores. Efforts to lower dementia risk factors, particularly in relation to reducing the negative impacts of disadvantage, are needed to curtail the growing burden of dementia.