Psychological Outcomes and Mechanisms of Mindfulness-Based Training for Generalised Anxiety Disorder: A Systematic Review and Meta-Analysis.

This systematic review aimed to identify 1) the effect of mindfulness training on pre-post measures of anxiety and attention among adults experiencing high levels of generalised anxiety; and 2) the impact of predictors, mediators and moderators on post-intervention changes in anxiety or attention. Trait mindfulness and distress measures were included as secondary outcomes. A systematic search was conducted in November 2021 in electronic databases using relevant search terms. Eight articles comprising four independent studies were included (N = 334). All studies included participants diagnosed with generalised anxiety disorder (GAD) who participated in an 8-week manualised program. The meta-analysis indicated that mindfulness training had a large effect on anxiety symptoms (g = -1.92, 95%CI[-3.44, -0.40]) when compared to inactive (i.e., care as usual, waitlist) or non-specified (i.e., condition not defined) controls. However, a significant effect was not found when compared to active controls. Effects for depression, worry and trait mindfulness did not reach statistical significance, despite small-large effect sizes favouring mindfulness compared to inactive/non-specified controls. Our narrative review found evidence that changes in aspects of trait mindfulness mediate anxiety reduction following mindfulness training. However, a small number of studies were available for inclusion in the review, with high risk of bias and low certainty of evidence present. Overall, the findings support the use of mindfulness training programs for GAD and indicate mechanisms that may differ from those involved in other cognitive therapy approaches. Further RCTs with evidence-based controls are needed to clarify techniques most beneficial for generalised anxiety to support individually tailored treatment. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04695-x.

Elucidating individuals' beliefs about the severity of eating disorders and obesity: implications for public health programs.

PURPOSE: To examine perceptions of the severity of eating disorders and obesity and the effects on these of an information manipulation while also considering the influence of potential covariates such as age, gender, physical and mental health and beliefs about the prevalence and causes of the respective conditions. METHODS: Australian women and men (n = 488) aged 18-73 years were randomly assigned to one of four conditions: no information, neutral information, eating disorders emphasis and obesity emphasis. Mixed-model analysis of variance (ANOVA) was used to compare the perceived severity of eating disorders and obesity (within-subjects factor), while also testing the effect of manipulating information, i.e., selectively emphasising the occurrence and adverse effects of one condition or the other (between-subjects factor), on perceptions of severity. Correlational analysis was used to examine associations between perceptions of severity and potential covariates, those covariates for which significant associations were observed being included as covariates in the ANOVA. RESULTS: Eating disorders were perceived to be a more severe condition than obesity and the information manipulation was largely ineffective. Perceptions of the severity of both eating disorders and obesity were found to be associated with several covariates, including gender, body dissatisfaction, familiarity with and beliefs about the prevalence of eating disorders and beliefs about the causes of both eating disorders and obesity. CONCLUSIONS: The findings support the need for-and provide a platform for-greater collaboration between obesity and eating disorder researchers in the development of integrated prevention and health promotion programs. LEVEL OF EVIDENCE: Level III.

Gambling Behaviour, Problem Gambling and Reasons for Gambling Among International Students in Tasmania, Australia.

Individuals who undertake tertiary study outside their home countries ("international students") may be at increased risk of problem gambling behaviour. To inform this issue, we examined gambling behaviour, problem gambling behaviour and reasons for gambling among international students, primarily from Asian countries, attending university in Tasmania, Australia. Online surveys that included established measures of each outcome were completed by these students (n = 382) along with a comparison group of domestic students (n = 1013). While most forms of gambling assessed were less common among international students than among domestic students, rates of problem gambling were higher among international students (2.6%) than among domestic (1.4%) students. Further, whereas rates of problem gambling did not differ by sex among domestic students, problem gambling among international students was confined to males. Hence, rates of problem gambling were markedly elevated in this subgroup (5% of all male international students, 15% of male international students who reported any form of gambling in the past 12 months). International students were more likely than domestic students to report engaging in gambling as a means of regulating their internal states and for a challenge and these and other reasons for gambling were positively correlated with problem gambling behaviour. The findings support the need for population- and campus-based health promotion and early intervention programs targeting international students, male students in particular. Information concerning individuals' reasons for gambling might usefully be included in these programs.

Psychological and attentional outcomes following acute mindfulness induction among high anxiety individuals: A systematic review and meta-analysis.

BACKGROUND: Training outcomes of mindfulness interventions for anxiety have been extensively researched. Less is known about the acute effects of mindfulness induction and associated mechanisms. This systematic review aimed to identify 1) the effect of mindfulness induction on pre-post measures of state anxiety and attention among adults experiencing high levels of anxiety; and 2) the impact of predictors, mediators and moderators on post-induction changes in anxiety and attention. State distress and mindfulness were included as secondary outcomes. METHODS: A systematic search was conducted in November 2021 in electronic databases using relevant search terms. Five studies (four randomised controlled trials and one non-randomised controlled trial) were included, comprising a total of 277 participants with elevated trait/generalised anxiety. Each study used a brief audio-based mindfulness induction exercise. RESULTS: The meta-analysis indicated mindfulness induction had medium and large effects on state anxiety (k = 3, n = 100, g = -0.60, 95%CI [-1.04, -0.16]; p = .008) and state mindfulness (k = 2, n = 110, g = 0.91, 95%CI [0.52, 1.30], p < .001), respectively, when compared with non-therapeutic control conditions. Furthermore, two studies showed small and moderate effects of mindfulness on state anxiety when compared to therapeutic active controls, but were not pooled in a meta-analysis. While results could not be pooled for attention, there was limited evidence of behavioural improvements on tasks measuring aspects of attention following mindfulness induction. However, one study found an increase in Low Beta to High Beta ratio and a reduction in Beta activity in the Anterior Cingulate Cortex following mindfulness induction. Moreover, another study found aspects of state mindfulness mediated reductions in state anxiety. LIMITATIONS: A small number of studies were included in the review, with high risk of bias and low certainty of evidence present. CONCLUSION: The findings support the use of mindfulness induction to reduce state anxiety in anxious individuals but suggest gains in state mindfulness may be a more realistic expected outcome. Further controlled trials are needed to delineate the relative effects of objectively assessed anxiety outcomes from mindfulness induction in clinically defined samples.

Social disinhibition in acquired brain injury and neurological disease: a concept analysis.

BACKGROUND: Social disinhibition is becoming increasingly recognised in the neuropsychological literature as a complex and debilitating sequalae associated with acquired frontal lobe damage. Despite this, the term has been inconsistently defined and described in both clinical and research contexts. The purpose of this paper was to explore and examine the concept of social disinhibition in the context of brain injury and other organic neurological conditions. METHOD: A literature search for articles published in the English language from journal inception to June 2021 was conducted using MEDLINE, PsycInfo, Embase, CINAHL and Web of Science. A 'concept analysis' was conducted on the identified literature using Walker & Avant's (2019) framework. RESULTS: The analysis suggested that while several terms are often used interchangeably with social disinhibition, including impulsivity and behavioural dysregulation, these terms may be differentiated and defined separately within the broader domain of 'behaviours of concern'. Attributes, antecedents and consequences of social disinhibition were also identified and discussed. CONCLUSIONS: Clarifying the concept of social disinhibition has important implications in both clinical and research contexts, including increased understanding of the behaviours, more accurate estimates of incidence and prevalence, and the development and implementation of targeted rehabilitation programmes.

Impacts of Community Resilience on the Implementation of a Mental Health Promotion Program in Rural Australia.

Mental health promotion programs are important in rural communities but the factors which influence program effectiveness remain unclear. The aim of this mixed-methods study was to assess how community resilience affected the implementation of a mental health promotion program in rural Tasmania, Australia. Four study communities were selected based on population size, rurality, access to local support services, history of suicide within the community, and maturity of the mental health promotion program. Data from self-report questionnaires (n = 245), including items of Communities Advancing Resilience Toolkit (CART) assessment, and qualitative (focus group and interview) data from key local stakeholders (n = 24), were pooled to explore the factors perceived to be influencing program implementation. Survey results indicate the primary community resilience strengths across the four sites were related to the 'Connection and Caring' domain. The primary community resilience challenges related to resources. Qualitative findings suggested lack of communication and leadership are key barriers to effective program delivery and identified a need to provide ongoing support for program staff. Assessment of perceived community resilience may be helpful in informing the implementation of mental health promotion programs in rural areas and, in turn, improve the likelihood of their success and sustainability.

Alcohol intoxication impairs recognition of fear and sadness in others and metacognitive awareness of emotion recognition ability.

Alcohol intoxication is linked to negative social behaviors, but the mechanisms underlying this relationship are poorly understood. We investigated the effects of high-dose alcohol intoxication on the ability to perceive a range of basic emotions (sad, happy, anger, disgust, fear, and surprise) of different intensities, and on self-appraisals of emotion perception ability (i.e., metacognitive judgments). Sixty-four participants consumed either an alcohol or placebo beverage. An emotion recognition task was used to assess emotion perception ability, and participants provided confidence ratings when providing each emotion recognition response. Alcohol-intoxicated individuals demonstrated a reduced ability to detect fear and sadness at moderate-to-high levels of emotion intensity and less overall insight into their ability to recognize emotions. These results provide new insights into the possible difficulties experienced by alcohol-intoxicated individuals in perceiving emotions in others and the limited capacity to monitor their emotion perception abilities, both of which may contribute to inappropriate social responding. (PsycINFO Database Record

Inhibiting automatic negative social responses in alcohol intoxication: interactions with theory of mind ability and level of task guidance.

RATIONALE: Alcohol intoxication is associated with socially disinhibited behaviours that may reflect impaired social cognitive abilities that guide social behaviour. The effects of alcohol on social cognition and how this may contribute to disinhibited behaviour are poorly understood. The aim of this study was to examine whether intoxicated individuals could inhibit automatic negative responses to negative social information, whether these difficulties were reliant on theory of mind (ToM) ability and whether intoxicated individuals were able to adjust verbal responses when provided with guidelines about how to respond. METHODS: Sixty-four participants aged between 18 and 34 (balanced for gender) consumed a beverage containing either placebo or alcohol calculated to achieve a target BrAC of 0.080%, before completing a Flanker task, a go/no-go task and a novel measure of social disinhibition, the social disinhibition task. RESULTS: Results indicate that alcohol-intoxicated individuals can inhibit negative responses to negative social information, but display difficulty inhibiting negative responses to social information that requires ToM. They also suggest that people under the influence of moderate-to-high-dose alcohol can adjust their responses when provided with specific guidelines on how to respond. CONCLUSIONS: These findings may have important implications for understanding negative alcohol-related behaviours and promote the consideration of social context, social pressure and social cognitive abilities in the development of public policy and targeted interventions to prevent alcohol-related antisocial behaviours.

Health and Well-Being of International University Students, and Comparison with Domestic Students, in Tasmania, Australia.

International students comprise an increasingly larger proportion of higher education students globally. Empirical evidence about the health and well-being of these students is, however, limited. We sought to examine the health and well-being of international students, primarily from Asian countries, attending the University of Tasmania, Australia, using domestic students as a comparison group. Ethics approval was given to invite (via email) all currently enrolled students to participate in the study by completing a pilot-tested, online survey. The survey was completed by 382 international students (response rate = 8.9%) and 1013 domestic students (9.2%). Independent samples t-tests, analysis of variance (ANOVA) and chi-square tests were used for bivariate comparisons between international and domestic students, and between subgroups of international students. Regression models were used to examine the associations between student status (international vs. domestic) and health outcomes, controlling for demographic and enrolment variables. International students, particularly male students, were found to be at increased risk of several adverse health outcomes while also being less likely to seek help for mental health and related problems. The findings indicate the need for accessible, targeted, culturally-sensitive health promotion and early intervention programs.