Melbourne School of Psychological Sciences - Research Publications
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ItemNo Preview AvailableMammography Adherence among High-Risk Women with Breast Cancer and Either a Non-Pathogenic Mutation Identified or Untested BRCA1/2 Genetic Status(IOS Press, 2020-11-06)Background: Little is known about the illness perceptions of women with a previous breast cancer diagnosis and either no access to a personal BRCA1/2 test or tested and a no pathogenic mutation identified result and how this might impact their mammography adherence. Objective: The aim of this study was to assess the impact of illness beliefs, specifically those relating to emotional representations and cure and control beliefs about breast cancer, and socio-economic status (SES) on mammography adherence of these women. The traditional health belief model (HBM) was compared to a modified model which allowed for the contribution of emotions in health surveillance decision-making. Method: Mailed self-report questionnaires were completed by 193 women recruited from an Australian Familial Cancer Centre. Step-wise logistic regression analyses were conducted on n=150 [aged 27-89 years (M=56.9)] for whom complete data were available. Results: The questionnaire response rate was 36%. Higher levels of emotional representations of breast cancer were associated with greater mammography adherence (OR = 1.18, 95% CI = 1.03-1.36, p =.019). Middle income was six times more likely to predict mammography adherence than lower income (OR = 6.39, 95% CI = 1.03 – 39.63, p =.047). The modified HBM was superior to the traditional HBM in predicting mammography adherence (X2 [15, N = 118] = 26.03, p =.038). Conclusions: Despite a modest response rate, our data show that emotional illness representations about breast cancer and middle income status were found to significantly predict mammography adherence. Therefore, providing surveillance services and delivering information considerate of financial status and constructed around emotional motivators may facilitate mammography adherence among women like those described in this study.
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ItemMindfulness-based cognitive group therapy for women with breast and gynecologic cancer: a pilot study to determine effectiveness and feasibility(SPRINGER, 2013-11)PURPOSE: Group-based mindfulness training is frequently described in psycho-oncology literature, but little is known of the effectiveness of mindfulness-based cognitive therapy (MBCT). We investigated the effectiveness and acceptability of MBCT for women with breast and gynecologic cancer. METHODS: Fifty women were recruited to participate in eight weekly 2-h mindfulness sessions. Outcomes of distress, quality of life (QOL), post-traumatic growth, and mindfulness were assessed pre-intervention, post-intervention, and again 3 months later using validated measures. Data were analyzed with repeated measures ANOVAs with a Bonferroni correction. Participant satisfaction and evaluation were also assessed. RESULTS: Forty-two women completed the program, and complete data were available for 36 women. Significant improvements with large effect sizes (ηρ(2)) were observed for distress (P < 0.001; ηρ(2) = 0.238), QOL (P = 0.001; ηρ(2) = 0.204), mindfulness (P < 0.001; ηρ(2) = 0.363) and post-traumatic growth (P < 0.001; ηρ(2) = 0.243). Gains were maintained 3 months post-intervention. Improvements in outcomes did not differ based on diagnostic group, psychological status, or physical well-being at entry. Change indices further support these findings. Scores on measures of distress, QOL, and post-traumatic growth decreased as a function of increased mindfulness at each time point (all P < 0.05). Participants reported experiencing the program as beneficial, particularly its group-based nature, and provided positive feedback of the therapy as a whole as well as its individual components. CONCLUSIONS: Within the limits of a non-randomized trial, these findings provide preliminary support for the potential psychosocial benefits of MBCT in a heterogeneous group of women with cancer. Future, more comprehensive trials are needed to provide systematic evidence of this therapy in oncology settings.
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ItemComparison of the acceptability and benefits of two mindfulness-based interventions in women with breast or gynecologic cancer: a pilot study(SPRINGER, 2015-04)PURPOSE: The aim of this study was to compare the relative benefits and acceptability of two different group-based mindfulness psychotherapy interventions among women with breast and gynecologic cancer. METHODS: Data from 42 women who completed an 8-week mindfulness-based cognitive therapy (MBCT) program comprising 22 contact hours were compared to data from 24 women who completed a 6-week mindfulness meditation program (MMP) comprising 9 contact hours. Distress, quality of life (QOL), and mindfulness were evaluated pre- (T1) and post-intervention (T2). ANCOVA was used to analyse the relationship between intervention type and T1 score on outcome variable change scores. Participants' perceptions of benefit and acceptability were assessed. RESULTS: The participants did not differ on clinical or demographic variables other than MBCT participants were more likely than MMP participants to have a past history of anxiety or depression (p = .01). Scores on distress, QOL, and mindfulness improved from T1 to T2 with medium to large effect sizes for the MMP (p=.002, d=.7; p=.001, d=.8; p=.005, d=.6, respectively) and MBCT (p<.001,d = .6; p=.008, d = .4; p<.001, d=.9, respectively) interventions. [correted]. ANCOVA showed no main effect for intervention type on outcome change scores and no interaction between intervention type and respective T1 score. Distress and mindfulness scores at T1 had a main effect on respective change scores (p = .02, ηp (2) = .87; p = .01, ηp (2) = .80, respectively). Both programs were perceived as beneficial and acceptable with no differences between the intervention types. CONCLUSIONS: Within the limits of a small, non-randomized study, these findings provide preliminary support for the utility of a brief mindfulness intervention for improving distress and QOL in a heterogeneous group of women with cancer. Abbreviated interventions are less resource intensive and may be attractive to very unwell patients.
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ItemEarly origins of mental disorder - risk factors in the perinatal and infant period(BMC, 2016-07-29)BACKGROUND: There is increasing understanding of the significance of early neurodevelopment in establishing risk for the range of mental disorders. Models of the early aetiology of mental disorders are complex with a range of potential factors from genetic and epigenetic to environmental influencing neurological and psychological development. Whilst the mechanisms are not fully understood, this paper provides an overview of potential biological and neurobiological factors that might be involved. METHOD: An aetiological model is presented and discussed. The discussion includes a range of risk factors for mental disorder. Maternal anxiety disorder is presented and reviewed as an example of the interaction of placental, epigenetic and early parenting factors elevating risk of poor neonatal outcome. RESULTS: Available evidence points to the importance of in-utero influences as well as the role of early attachment and emotional care. Transgenerational mechanisms such as the impact of maternal mental disorder on foetal development are important models for examination of early risk. Maternal anxiety, as an example, is a significant risk factor for compromised mental health. CONCLUSIONS: Development of models for understanding the early origins of mental disorder is an important step in elaborating risk reduction strategies. Comprehensive early identification of risk raises the possibility of preventive interventions.
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ItemValidation of the Drinking Motives Questionnaire (DMQ) in older adults(PERGAMON-ELSEVIER SCIENCE LTD, 2013-05)Drinking motives have been established as an important construct in the prediction of alcohol use and drinking problems among younger adults, but there is little understanding about the drinking motivations of older adults. Although emerging evidence shows the importance of studying older adults' own reasoning for their alcohol consumption, measures that have been used to assess such reasons lack psychometric assessment. This study aims to validate the three-dimensional structure of the Drinking Motives Questionnaire (DMQ) in older adults and to investigate the relationships between drinking motives and alcohol use. A sample of community dwelling older adults (N=370) completed self-report measures assessing drinking behavior and motives for drinking. Using confirmatory factor analysis, the results supported a three-factor model of drinking motives. Multi-group analysis of invariance showed support for configural and metric invariance, and partial support was met for scalar invariance. Social motivations for drinking were the most frequently endorsed, followed by enhancement, and coping motives. Males reported more frequent drinking for each of the three motives. Social motives were consistently related to drinking behaviors and coping had a direct relationship to drinking problems. Overall, the study shows that the DMQ has promise as a measure for use with older adults.
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ItemChanging places: the impact of rural restructuring on mental health in Australia(ELSEVIER SCI LTD, 2005-06)Significant demographic, social and economic change has come to characterise much of rural Australia, with some authors arguing there are now two sharply differentiated zones, one of growth and one of decline. This restructuring process, which has been similar to other western nations, has had a profound impact upon rural places-socially, economically and physically. Findings from research investigating the relationship between health, place and income inequality suggest that rural 'desertification', which is characterised by decline of the agricultural sector, net population loss and the deterioration of demographic structures, may negatively influence mental health outcomes in these areas. By contrast, the growth in rural areas, which is associated with expanding employment opportunities and the movement of capital and people, may confer positive benefits to mental health. The aim of this study was to investigate differences in mental health and well-being between rural communities experiencing growth and decline as measured by net population change. Utilising a survey methodology, questionnaires were distributed to 20,000 people randomly sampled from the electoral role in rural Australia. We selected four sub-regions from the sample area that were characteristic of areas experiencing population growth and decline in Australia and analysed the results of respondents from these four regions (n = 1334). The analysis provided support for our hypothesis that living in a declining area is associated with poorer mental health status; however, the factors that underpin growth and decline may also be important in influencing mental health. Discussed are the mechanisms by which demographic and social change influence mental health. The findings of this study highlight the diversity of health outcomes in rural areas and suggest that aspects of place in declining rural areas may present risk factors for mental health.