A Cluster Analysis of Sleep Quality, Self-Care Behaviors, and Mental Health Risk in Australian University Students.

Background: University students have high levels of poor sleep quality (SQ) and mental health, and low adherence to healthy nutrition and physical activity (PA). Objective: This study examined what clusters of self-care behaviors (SCB) were associated with SQ and mental health in Australian university students. Method: 355 Australian university students, ranging in age from 18 to 24 years (M = 20, SD = 1.5, 286 females) completed surveys relating to fruit and vegetable consumption, alcohol binge behavior, PA, mental health measured by the Depression Anxiety Stress Scales 21, and SQ measured by the Pittsburgh SQ Index (PSQI). Fruit and vegetable consumption, alcohol binge behavior, and PA were assessed according to current Australian guidelines. Results: Almost two thirds of participants (62.0%) met the criteria for poor SQ. Good SQ was significantly associated with meeting PA guideline levels (rb = .14) and inversely associated with higher levels of depression (rpb = -.34), anxiety (rpb = -.36), and stress levels (rpb = -.42). Four distinct SCB and mental health risk clusters were created. The "healthiest SCB" cluster had 1.6 times better SQ than the average. This cluster had higher levels of moderate and vigorous PA, higher levels of fruit consumption, and less binge drinking, the least sedentary behavior, and the lowest levels of depression, anxiety, and stress compared to the other clusters. Conclusion: This research corroborates with previous literature on the importance of regular vigorous PA as a lifestyle intervention to facilitate better sleep outcomes and improved mental health outcomes in university students.

The relationship between mindfulness facets, depression, pain severity and pain interference.

The high prevalence of depression among chronic pain populations is well-established: however, treatments for both depression and chronic pain remain only moderately effective. Previous research has indicated that mindfulness is a promising treatment pathway for both depression and chronic pain, however, the mechanisms of change underlying mindfulness are unclear. The purpose of this study was to examine the effects of the mindfulness facets on depression and pain, using two pain measures; severity and interference. One hundred and fifty-eight Australian females and 32 males with chronic pain participated in the study. Higher levels of mindfulness were associated with lower depression as well as lower pain. Path models using depression as a mediator, found that the mindfulness facets observing and describing had a direct effect on pain, while non-judgement, non-reactivity and describing showed indirect effects on pain through depression. Greater effects were seen for pain interference compared to pain severity, highlighting its importance as a potential treatment outcome. Future research should continue to analyse the effects of the mindfulness facets and consider using pain interference as a core treatment outcome.

"Sons of the West" leadership academy: Examining impact on community connectedness, leadership and self-efficacy.

ISSUE ADDRESSED: Australian men experience poorer health, have reduced help-seeking behaviours, engage in unhealthy coping mechanisms and suicide rates are disproportionately high, compared to Australian women. The "Sons of the West" (SOTW) Premiership Program is an Australian men's physical and mental health promotion program, which includes a Leadership Academy (LA), so that Premiership Program graduates can further develop skills and become leaders in improving male health. The aim of this research study was to determine if the SOTW Leadership Academy improved community connectedness, leadership attributes and self-efficacy amongst LA graduates. METHODS: Sixty-seven Australian males (M = 53.42, SD = 11.80, age range: 20-72), from two groups (Premiership Program graduates who completed the LA and those who only completed the Premiership Program) completed three self-rated questionnaires on community connectedness, self-efficacy and leadership qualities. RESULTS: There was a significant difference between the two groups, showing that LA graduates had increased levels of leadership skills, self-efficacy and community connectedness compared to those who did not complete the LA. CONCLUSION: This study indicates that a men's health program can not only engage and improve the health of men, but also help them develop skills and enhance their own strengths, so that they can improve the health and well-being of others. SO WHAT?: The development of leadership pathways and capacity building, embedded within health promotion programs, is an important aspect of improving health and well-being.

Evaluation of the Cardiac Depression Visual Analogue Scale in a medical and non-medical sample.

Comorbid depression and medical illness is associated with a number of adverse health outcomes such as lower medication adherence and higher rates of subsequent mortality. Reliable and valid psychological measures capable of detecting a range of depressive symptoms found in medical settings are needed. The Cardiac Depression Visual Analogue Scale (CDVAS) is a recently developed, brief six-item measure originally designed to assess the range and severity of depressive symptoms within a cardiac population. The current study aimed to further investigate the psychometric properties of the CDVAS in a general and medical sample. The sample consisted of 117 participants, whose mean age was 40.0 years (SD = 19.0, range 18-84). Participants completed the CDVAS, the Cardiac Depression Scale (CDS), the Depression Anxiety Stress Scales (DASS) and a demographic and health questionnaire. The CDVAS was found to have adequate internal reliability (α = .76), strong concurrent validity with the CDS (r = .89) and the depression sub-scale of the DASS (r = .70), strong discriminant validity and strong predictive validity. The principal components analysis revealed that the CDVAS measured only one component, providing further support for the construct validity of the scale. Results of the current study indicate that the CDVAS is a short, simple, valid and reliable measure of depressive symptoms suitable for use in a general and medical sample.

Burnout in Australian psychologists: correlations with work-setting, mindfulness and self-care behaviours.

Burnout is an inherent risk for those working as mental health professionals, given the nature of their work. Due to recent Medicare changes in Australia, private practice psychologists were suspected to face similar burnout risks as non-private practitioners. The aim of the present study was to investigate the relationships among burnout in Australian psychologists, work-setting and years of experience in that setting, mindfulness and career-sustaining behaviours (CSBs). 145 Females and 22 male Australian registered psychologists, with a mean age of 42.47 years (SD = 11.64, range 24-68), were surveyed to determine work-setting, mindfulness, burnout and preferences for CSBs. High levels of burnout were reported among Australian psychologists. No significant difference in burnout between psychologists working in private-practice and non-private-practice settings was found. There was a strong negative relationship between mindfulness and burnout and there was a low but significant negative relationship between years of experience in current work-setting and burnout levels. CSB preferences only had weak relationships with burnout, which decreased after controlling for mindfulness. Several CSBs that had a detrimental relationship with burnout were identified and may be worthy of further investigation. Developing strategies to increase mindfulness may prevent burnout in Australian psychologists.

Co-morbid depression and chronic illness related to coping and physical and mental health status.

A partial latent structural regression analysis was used to evaluate the role of coping resources, depression, diet and exercise on mental and physical health status. The sample consisted of 113 participants (59 females and 54 males) with a mean age of 59.38 years (SD = 10.52). Coping resources, depression and exercise explained 52 and 26% of the variance in mental and physical health status, respectively. Fewer coping resources predicted higher levels of depression and both predicted worse mental health. Only higher levels of depression predicted worse physical health status. There were also significant indirect effects of coping on mental and physical health status through depression. The development of cognitive, social and emotional coping strategies is important for managing depression and supporting positive mental health. These results highlight the important role of health psychologists in the care of individuals with chronic illness. Additionally, the management of depression is important in maintaining positive physical health.

Differences in Anxiety, Insomnia, and Trauma Symptoms in Wildfire Survivors from Australia, Canada, and the United States of America.

Many survivors of wildfires report elevated levels of psychological distress following the trauma of wildfires. However, there is only limited research on the effects of wildfires on mental health. This study examined differences in anxiety, depression, insomnia, sleep quality, nightmares, and post-traumatic stress disorder (PTSD) symptoms following wildfires in Australia, Canada, and the United States of America (USA). One hundred and twenty-six participants from Australia, Canada, and the USA completed an online survey. The sample included 102 (81%) women, 23 (18.3%) men, and one non-binary (0.8%) individual. Participants were aged between 20 and 92 years (M age = 52 years, SD = 14.4). They completed a demographic questionnaire, the Disturbing Dream and Nightmare Severity Index (DDNSI), Generalized Anxiety Disorder Questionnaire (GAD-7), the Insomnia Severity Index (ISI), Patient Health Questionnaire (PHQ-9), the Pittsburgh Sleep Quality Index (PSQI), and PTSD Checklist (PCL-5). Results showed that participants from the USA scored significantly higher on the GAD-7 (p = 0.009), ISI (p = 0.003), and PCL-5 (p = 0.021) than participants from Australia and Canada. The current findings suggest a need for more international collaboration to reduce the severity of mental health conditions in Australia, Canada, and the USA.

A Systematic Review of the Impact of Wildfires on Sleep Disturbances.

Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compromise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings pertaining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63-72.5%) and nightmares (ranging between 33.3-46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associations between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires.

Diet, Physical Activity, and Screen Time to Sleep Better: Multiple Mediation Analysis of Lifestyle Factors in School-Aged Children with and without Attention Deficit Hyperactivity Disorder.

OBJECTIVE: This study examined the mediation roles of multiple lifestyle factors in school-aged children. Structural equation modeling (SEM) tested how lifestyle factors play mechanism roles one another in the impact of ADHD to seek theoretical and intervention insights. METHOD: An online survey assessed children's lifestyle factors including diet, physical activity, screen time, sleep difficulties, and having ADHD diagnosis. A multi-country sample from English speaking nations included 309 caregivers. Multiple regression and SEM were planned to identify significant correlates and mediators of ADHD in explaining lifestyle differences. RESULTS: Preliminary multiple regression showed only sleep quality was significantly different between children with and without ADHD. Significant triple mediation effects suggested diet, physical activity, and screen time mediated the ADHD impact on sleep quality. CONCLUSION: Researchers and practitioners may incorporate the findings to develop intervention models for children with ADHD attending to the mediational roles of lifestyle factors to improve sleep quality.

The course of depression 10-weeks post-acute coronary syndrome: assessment using the cardiac depression visual analogue scale.

This study investigated depressed mood post-acute coronary syndrome in an Australian sample using the Cardiac Depression Visual Analogue Scale (CD-VAS), which was developed to assess the depression-related symptoms of reduced pleasure, memory, activity, future pessimism, increased irritation and sleep problems. The Beck Depression Inventory-II, the Cardiac Depression Scale (CDS) and a demographic medical questionnaire were administered at 2 weeks post-ACS to an initial sample of 13 female and 45 male participants whose mean age was 59.16 (SD=11.13) years (range 38-79). Depressed and non-depressed participants, determined by the CDS, then kept a CD-VAS diary between 2 and 12 weeks. 32 participants kept the diary for the entire 10 weeks. Total CD-VAS scores remained elevated in the depressed group for the entire period. The groups differed on the Pleasure, Memory and Future items for a total of 6, 6 and 5 weeks, respectively, and differed on the Activity item only at 1, 3 and 5 weeks. No group differences were seen in the Irritation or Sleep items. Within the depressed group, the only CD-VAS items that differed from each other across time were Irritation and Activity. Further, the Sleep, Irritation and Activity items had a significant time effect. These results indicate that although overall depression, as measured by the CD-VAS, remained elevated in the depressed group, there were key differences in recovery rates of specific depression-related symptoms. These differences could be useful indicators in the treatment of depression post-ACS.

Depression following acute coronary syndromes: a comparison between the Cardiac Depression Scale and the Beck Depression Inventory II.

OBJECTIVE: This study compared the Cardiac Depression Scale (CDS) and the Beck Depression Inventory II (BDI-II). METHOD: Depression was assessed in 81 participants, 2 weeks post-ACS, using the BDI-II and the Composite International Diagnostic Interview. RESULTS: The CDS had a strong concurrent validity with the BDI-II (r=.69). Cross-validation of the BDI-II and the CDS with the structured interview demonstrated the ability of both measures to detect severe symptoms. More patients were classified as depressed using the CDS. The CDS also had a significantly higher correlation with a trait anxiety measure than the BDI-II did. CONCLUSION: The CDS is a more suitable scale for assessing the less severe depressive symptoms typically seen in a cardiac population.

A Cardiac Depression Visual Analogue Scale for the brief and rapid assessment of depression following acute coronary syndromes.

OBJECTIVE: A Cardiac Depression Visual Analogue Scale (CD-VAS) was developed as a rapid and easy method of assessing depressed mood in a cardiac population. The CD-VAS was contrasted against the Cardiac Depression Scale (CDS) and the Beck Depression Inventory-II (BDI-II). METHOD: Depression was assessed in 58 participants, 2 weeks postacute coronary syndrome (ACS), using the BDI-II and the CDS. Participants then completed the six-item CD-VAS for 14 consecutive days. RESULTS: Using mean weekly scores, the CD-VAS had strong internal reliability (.91) and strong test-retest reliability that ranged from .85 to .97. Principal components analyses found that the CD-VAS only measured one component. The CD-VAS had strong concurrent validity with the BDI-II (r=.81) and the CDS (r=.82) and was able to differentiate between depressed and nondepressed participants. CONCLUSION: The CD-VAS is a valid and reliable measure for brief and rapid repeated assessments of depressive symptoms in a cardiac population.

The relationships among self-care, dispositional mindfulness, and psychological distress in medical students.

BACKGROUND: Past research suggests that medical students experience high levels of psychological distress. OBJECTIVE: The aim of the current study was to investigate the relationships among engagement in self-care behaviours, dispositional mindfulness, and psychological distress. METHODS: The sample consisted of 139 female and 68 male Australian medical students (N=207) aged 17-41 years (M=21.82, SD=3.62) across the 5 years of the Monash University medical course. Participants completed an online survey comprising a demographics questionnaire, the Five Facet Mindfulness Questionnaire, the Health-Promoting Lifestyle Profile II, and the Depression, Anxiety, and Stress Scales. RESULTS: Results revealed significant and interpretable multivariate correlations between distress and both mindfulness and self-care. Furthermore, the dispositional mindfulness observation subscale was found to be a significant moderator of the relationship between several dimensions of self-care and psychological distress. CONCLUSIONS: The present study points to the potential of self-care and mindfulness to decrease medical student distress and enhance well-being.

Evaluating the psychometric properties of the attitudes towards depression and its treatments scale in an Australian sample.

BACKGROUND: Individuals' attitudes towards depression and its treatments may influence their likelihood of seeking professional help and adherence to treatment when depressed. Objective measures, such as the Attitudes Towards Depression and its Treatments scale (ATDT), have been developed to assess such attitudes. The aims of this research were to test the reliability and validity of ATDT on an Australian sample who were not depressed during the study or who had previously been depressed, to explore the attitudes of the Australian public towards depression, and to compare these attitudes to those of a Canadian sample of people with depression. METHODS: A sample of 63 males and 140 females (mean age = 32.2 years, SD = 12.9 years) from Melbourne, Australia took part in this study. Fourteen of the males and 52 of the female participants (mean age = 35.4 years, SD = 13.2 years) stated that they had been previously diagnosed with depression. RESULTS: THE ATTITUDES OF THE AUSTRALIAN SAMPLE AND THE SUBSET OF THAT SAMPLE WHO HAD PREVIOUSLY EXPERIENCED DEPRESSION DIFFERED FROM THOSE OF THE CANADIAN OUTPATIENT SAMPLE: they were less ashamed of depression, more likely to take antidepressants and consider psychotherapy, and more likely to seek help from professionals or significant others in their lives. However, those in the Australian sample were more likely to report that antidepressants made them lose control, and they were less willing to consider electric shock as a treatment option for their depression. The internal reliability as measured by Cronbach's alpha was lower in the current study (0.63 and 0.57 for both the general public and the depressed Australian sample) than in the Canadian study. Confirmatory factor analysis failed to replicate the factor structure reported previously. LIMITATIONS: The Australian sample of this study may be underrepresentative due to the sampling methods used, and the high proportion of females should not be overlooked. CONCLUSION: Researchers should be vigilant when utilizing measures constructed in different countries. In comparison to the Canadians, the selected Australian sample had more positive attitudes towards depression and its available treatments. The ATDT scale was not a reliable and valid measure in this sample.

A biopsychosocial model for depressive symptoms following acute coronary syndromes.

A partial latent structural regression analysis was used to evaluate the influence of perceived stress and coping resources on depression following acute coronary syndromes (ACS) in a sample of 113 participants (25 females and 88 males with a mean age of 57.61 years (SD = 12.63). Out of them, 55 participants were Australian born and 48 were born elsewhere, with 53 of the patients scoring in the mild to high depression range on the Beck Depression Inventory and the Cardiac Depression Scale. Perceived stress and coping resources, after controlling for age and smoking explained 89% of the variance in the latent variable depression. Higher perceived stress levels and fewer coping resources predicted higher levels of depression. Higher levels of perceived stress predicted fewer coping resources and fewer coping resources predicted higher levels of depression. There was a significant direct and indirect effect of perceived stress through coping on depression. Cognitive and physical coping resources were the best predictors of the depression construct. These results have potential implications for the treatment of depression post-ACS. In particular, cognitive and physical coping mechanisms and perceived stress reduction need to be addressed when treating depression post-ACS.

The role of coping, anxiety, and stress in depression post-acute coronary syndrome.

Depressive symptoms are common and can affect prognosis following acute coronary syndromes (ACS). This study examined the psychological factors, coping, anxiety, and perceived stress associated with depression following ACS. Psychological variables were assessed in 15 females and 66 males (M = 57 years, SD = 12). Repeated measures at 2, 12, and 24 weeks post-ACS compared depression, anxiety, perceived stress, and coping resources as determined by the Cardiac Depression Scale, Beck Depression Inventory-II, State Trait Anxiety Inventory, Perceived Stress Scale, and Coping Resources Inventory. Depression, anxiety, and perceived stress remained high in the depressed group across time. Coping scores at 2 weeks post-ACS predicted depression scores at 24 weeks post-ACS. It appears that trait anxiety and coping resources are related to depressive symptoms post-ACS.