The Psychological Impacts of Pill Dysphagia: A Mixed Methods Study.

Pill dysphagia is a common problem amongst older adults, with significant health consequences. Previous research has found that dysphagia can negatively affect an individuals mental health and wellbeing. However, this research has not been extended to pill-specific dysphagia, which presents distinct differences from the challenges posed by swallowing food and liquids. These differences extend to causes, demographics, and physical health ramifications. This study aimed to address this gap in the literature by investigating the effects of pill dysphagia on the wellbeing of older adults. A community sample of 132 Australians aged 65-97 years completed a survey about their wellbeing and difficulty swallowing pills. Thirty-one participants who met the criteria for pill dysphagia completed further open-ended questions detailing the effects of pill dysphagia and how they manage it. Analyses of the quantitative data indicated that difficulty swallowing pills was unrelated to negative affect but negatively related to positive affect, life satisfaction, and eudemonic wellbeing. Supplementary analyses controlling for health-related variables found no significant relationships between difficulty swallowing pills and wellbeing. Responses to the open-ended questions revealed a range of physical, psychological, and practical impacts of pill dysphagia, and successful and unsuccessful methods used to assist in swallowing pills. The findings partially support the hypothesised effects of pill dysphagia on wellbeing. However, further research is required to establish if more severe pill dysphagia predicts wellbeing over and above self-rated health. Future interventions should incorporate wellbeing promotion strategies for older adults with pill dysphagia.

"You say you're inclusive, but can you show us?" The importance of cultural competence when working with sexual minorities in a mental health setting.

OBJECTIVES: Sexual minorities experience higher rates of psychological distress than heterosexual people, likely due to minority stress. While rates of help-seeking by sexual minorities are high, sexual minorities report greater dissatisfaction with mental health service providers. This dissatisfaction may result from poor cultural competence practices. Our study sought to determine the importance of service provider cultural competence practices to a community sample of sexual minority people. METHODS: Participants (n = 274) were sexual minority Australians recruited from affirming Facebook groups, organizations, and research-based organizations. To measure the importance of cultural competence practices, participants completed a modified online version of the Gay Affirming Practices Scale (GAP) and responded to open-ended questions. RESULTS: Between 80% and 99% of participants endorsed each item on the GAP, indicating the importance of service providers demonstrating an array of culturally affirming practices. No significant associations were found between overall GAP score and age or sexual orientation, though further analyses revealed individual items on the GAP showed associations with age. A structured tabular thematic analysis, of open-ended participant responses, found positive attitudes, knowledge, and affirming practices were the three most important characteristics for service providers seeking to demonstrate culturally competent practices, mirroring the tripartite model (attitudes, knowledge, and skills) of cultural competence. CONCLUSION: Recommendations for service providers to demonstrate cultural competence include: utilizing affirming practices such as inclusive language, increasing knowledge about sexual minorities, and utilizing education resources such as cultural competence workshops, lived experience stories, and seeking mentorship from service providers with expertise in working with sexual minorities.

A systematic review to determine how service provider practises impact effective service provision to lesbian, gay and bisexual consumers in a mental health setting.

Lesbian, gay and bisexual (LGB) consumers utilize mental health services at a similar rate to their heterosexual counterparts yet report greater dissatisfaction with service quality. This dissatisfaction may be explained by service provider's microaggressions, stemming from a lack of cultural competence in working with LGB consumers. This systematic review examines how the practises of mental health service providers impacted effective service provision to LGB people in a clinical practice. Five health databases (Scopus, MEDLINE, PsycINFO, Web of Science and CINAHL) were examined to determine relevant studies for this review. Twenty four qualitative and quantitative studies between 2000 and 2020 examining data related to how service provider practises impacted effective service provision to LGB people were included in the final review. A narrative synthesis, thematic summary approach was employed to account for the multi-method nature of the data. Themes developed in our analysis are organized under the three components of cultural competence, service provider attitudes, knowledge and skills. Provider attitudes ranged from positive to negative towards LGB people and heterosexism were present in several services. Poor service provider knowledge about the issues impacting LGB consumers leads to a weakened therapeutic alliance and service providers often lacked a comprehensive understanding of the issues impacting LGB people. Service providers were seen as more skilful if they were LGB, created a safe space and had completed cultural competence training. Trends within the characteristics (explorative nature, mixed service provider samples, potential for bias) of the 24 studies included in the review are discussed. Based on the results, recommendations are included to ensure services demonstrate cultural competence in working with LGB consumers.

Psychometric validation of the Emerging Adult Stress Inventory (EASI).

Emerging adulthood is characterized by a prolonged transition from adolescence into adult roles and responsibilities. During this time, changes across multiple life domains can elicit stress, and while the impact of this has received substantial attention, measurement across different domains has been inconsistent. The ability to assess both the global stress experience and specific stressor domains (such as in family, peer and romantic relationships, study, work, finances, competing priorities and the future) would be valuable in understanding and addressing the impact of stress on well-being during this period. Informed by the Adolescent Stress Questionnaire, this study sought to design and evaluate the psychometric properties of a multidimensional self-report stress scale for use in emerging adults. The factor structure and validity of the self-report instrument was examined in two large community samples of emerging adults (Nsample1 = 760, Nsample2 = 546) aged 18 to 25 years. A series of exploratory factor analyses yielded eight internally reliable dimensions of emerging adult stress which were then validated with confirmatory factor analysis against univariate and hierarchical models. The derived scale scores related positively to established measures of general stress, anxiety and depression, and negatively to self-esteem, supporting their validity as measures of emerging adult stress. Associations across the domains with age and gender are also reported. The resultant 39-item Emerging Adult Stress Inventory offers a multidimensional self-report stress measure for emerging adults which enables investigation of specificity in the relationship between stress and well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Reducing anorexia nervosa stigma: an exploration of a social consensus intervention and the moderating effect of blameworthy attributions.

Background: Research suggests that blameworthy attributions towards individuals with anorexia nervosa are common, which in turn elicit more stigmatising attitudes towards those with the disorder. The social consensus approach has been found to reduce stigmatising attitudes in various domains and, as such, is a promising avenue to pursue for ameliorating stigma in anorexia nervosa.Aims: The present study primarily sought to investigate the effectiveness of a social consensus approach in reducing stigma towards individuals with anorexia nervosa. The study also examined if blameworthy attributions were associated with change in stigma.Method: An experimental design was employed, where female undergraduate students (N= 126) completed self-report measures that assessed anorexia nervosa stigma at baseline (Time 1) and 6-10 days after allocation to one of two conditions: social consensus and control (Time 2).Results: The social consensus intervention was more effective than the control condition in reducing stigmatising attitudes on measures assessing affective reactions (p= 0.025) and characteristics attributed to a target with anorexia nervosa (p < 0.001). Level of blame-based attributions did not moderate change in stigma.Conclusions: Results suggest that a social consensus intervention is promising irrespective of the endorsement of blameworthy attributions.

Re-examining the reciprocal effects model of self-concept, self-efficacy, and academic achievement in a comparison of the Cross-Lagged Panel and Random-Intercept Cross-Lagged Panel frameworks.

BACKGROUND: The cross-lagged panel (regression) model (CLPM) is the usual framework of choice to test the longitudinal reciprocal effects between self-concept and achievement. Criticisms of the CLPM are that causal paths are over-estimated as they fail to discriminate between- and within-person variation. The random-intercept cross-lagged panel model (RI-CLPM) is one alternative that extends the CLPM by partialling out between-person variance. AIMS: We compare analyses from a CLPM and a RI-CLPM which examine the reciprocal relationships between self-concept, self-efficacy, and achievement and determine the extent CLPM estimates are inflated by between-person variance. SAMPLE(S): Participants (n = 314) were first-year undergraduate psychology students recruited as part of the STudent Engagement with Education and Learning (STEEL) project. METHODS: Participants completed measures of self-efficacy and self-concept prior to completing fortnightly quiz assessments. RESULTS: Cross-Lagged Panel (regression) Model estimates are likely over-estimated in comparison with RI-CLPM estimates. Cross-Lagged Panel (regression) Model analyses identified a reciprocal effects relationship between self-concept and achievement, confirming established literature. In RI-CLPM analyses, these effects were attenuated and a skill development association between achievement and self-concept was supported. A reciprocal relationship between self-efficacy and achievement was supported. Better model fit was reported for the RI-CLPM analyses. CONCLUSIONS: Prior findings relating to the reciprocal effects of self-concept and achievement need to be reconsidered. Whilst such a relationship was supported in a CLPM analysis in this study, within an RI-CLPM framework, only achievement predicted self-concept. However, in both CLPM and RI-CLPM models a reciprocal effects model of self-efficacy and achievement was supported.

Age, sex and period estimates of Australia's mental health over the last 17 years.

OBJECTIVE: Describing the long-term mental health of Australians is limited as many reports rely on cross-sectional studies which fail to account for within-person changes and age-related developmental processes which may bias estimates which ignore these phenomena. We examined the 17-year trajectories of mental health in 27,519 Australian adults. METHODS: Household panel data of 27,519 participants aged 18 years and over from the Household, Income and Labour Dynamics in Australia Survey provided at least one observation of mental health over a 17-year period from 2001. On average, participants reported 7.6 observations. Mental Health was assessed annually using the Short-Form Health Survey-36 mental health scale. RESULTS: Over time, there were only very small changes in mental health and only for the youngest and oldest adults. Over time, there was consistent evidence for better metal health with increasing age, although for the very old, there appear to be substantial declines. These patterns were consistent between sex. In line with an existing literature, males reported better mental health over life span, although the declines of mental health in very-late-life are particularly pronounced for males. CONCLUSION: Decline in mental health was only reported by the youngest and oldest respondents, and was notable only in the last 4-5 years. However, the magnitude of the decline was small and further follow-up will be needed to determine whether this is a trend of substantive declining mental health for these specific age cohorts. In contrast, the more consistent finding is that there has been no substantive change in the level of mental health in Australia over the last 17 years. Analysis of the mental health trajectories of baseline age-cohorts confirmed that age differences are consistent over time.

The long-term mental health of Australia's tertiary students.

PURPOSE: The objective of the current study was to quantify the extent to which Australia's tertiary students have reported poorer mental health in comparison with the general community between 2001 and 2017. METHODS: Data were derived from the Household, Income and Labour Dynamics in Australia Survey, a longitudinal household-based panel study. There were 29,124 participants who provided at least one observation over the study period. On average, participants provided 7.4 observations. Mental Health was assessed with the SF-36 mental health and vitality subscales. RESULTS: There was little evidence for differences in mental health and vitality between those studying at tertiary levels and those not in tertiary education. Age-stratified analyses revealed that any differences were reported by older students. Interactions between education level and time revealed that the association between tertiary study and mental health outcomes has been consistent over time. CONCLUSION: There were very few differences between those in and those not in tertiary education. The magnitude of any differences was very small and does not necessarily reflect substantial poor mental health outcome. Overall, the most consistent finding was that there was little risk for poor mental health outcomes attributed to tertiary study.

Examining coping style and the relationship between stress and subjective well-being in Australia's 'sandwich generation'.

OBJECTIVE: The sandwich generation represents adults, often in midlife, who care for both children and ageing parents/relatives. While the stress they experience has received some attention, little research has investigated the subjective well-being (SWB) of this population. This study examined the relationship between perceived stress and SWB and the moderating effect of coping style. METHODS: Ninety-three participants (80 women), aged 23-63 years, completed an online survey measuring perceived stress, coping strategies, life satisfaction and positive and negative affect. RESULTS: Stress was negatively associated with SWB. While emotion- and problem-focused coping were directly associated with SWB outcomes, the only moderating effect found was for avoidance-focused coping (AFC). Specifically, AFC was associated with higher positive affect for those reporting lower stress. CONCLUSION: This study highlights the need to recognise the distinct circumstances that exist for the sandwich generation. Limitations and suggestions for future research are discussed.

Enhancing positive body image: An evaluation of a cognitive behavioral therapy intervention and an exploration of the role of body shame.

This study investigated the effectiveness of a 6-week cognitive-behavioral group intervention in promoting the development of positive body image. The study also examined if, in accordance with the objectification theory, participants who reported higher levels of body shame would (a) report higher levels of body dissatisfaction, and (b) demonstrate less improvement in response to the Positive Bodies program. A total of 52 women aged 17-54 years completed self-report measures of self-esteem, body area satisfaction, body image quality of life, body shame, and self-surveillance at the commencement and conclusion of the program. The results provided preliminary support for the overall effectiveness of the program. Contrary to predictions, higher body shame was associated with greater improvements in indicators of body image over time. Further comparisons with a control or treatment comparison group are required; however, the results support benefits for individuals with body dissatisfaction, particularly those reporting higher levels of body shame.

Reducing Depression Through an Online Intervention: Benefits From a User Perspective.

BACKGROUND: Internet interventions are increasingly being recognized as effective in the treatment and prevention of mental health conditions; however, the usefulness of such programs from the perspective of the participants is often not reported. OBJECTIVE: This study explores the experiences of participants of a 12-week randomized controlled trial of an automated self-help training program (e-couch), with and without an Internet support group, targeting depression. METHODS: The study comprised a community sample of 298 participants who completed an online survey both prior to and on completion of an intervention for preventing or reducing depressive symptoms. RESULTS: Overall, participants reported a high level of confidence in the ability of an online intervention to improve a person's understanding of depression. However, confidence that a website could help people learn skills for preventing depression was lower. Benefits reported by participants engaged in the intervention included increased knowledge regarding depression and its treatment, reduced depressive symptoms, increased work productivity, and improved ability to cope with everyday stress. A minority of participants reported concerns or problems resulting from participation in the interventions. CONCLUSIONS: The findings provide consumer support for the effectiveness of this online intervention. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 65657330;http://www.isrctn.com/ISRCTN65657330 (Archived by WebCite at http://www.webcitation.org/6cwH8xwF0).

Participating in online mental health interventions: who is most likely to sign up and why?

Internet-based interventions are increasingly recognized as effective in the treatment and prevention of mental disorders. However, little research has investigated who is most likely to participate in intervention trials. This study examined the characteristics of individuals interested in participating in an online intervention to improve emotional well-being and prevent or reduce the symptoms of depression, factors reported to encourage or discourage participation, and preferences for different intervention types. The study comprised 4761 Australians participating in a survey on emotional health. Comparisons are made between those who expressed an interest in participating in the trial and those who were not. Compared to those who declined to participate, interested participants were more likely older, females, separated/divorced, and highly educated, have reported current or past history of depression, report higher depressive symptoms, and have low personal stigma. Despite the flexibility of online interventions, finding time to participate was the major barrier to engagement. Financial compensation was the most commonly suggested strategy for encouraging participation. An increased understanding of factors associated with nonparticipation may inform the design of future e-mental health intervention trials. Importantly, consideration needs to be given to the competing time pressures of potential participants, in balance with the desired study design.

What are older adults seeking? Factors encouraging or discouraging retirement village living.

AIMS: (1) To identify factors that older adults find encouraging or discouraging about the prospect of relocation to a retirement village; and (2) to identify features or facilities often associated with retirement communities that are most appealing to prospective residents. METHOD: Randomly selected community residents (n = 517), aged 55-94 years, from the Australian Capital Territory completed postal surveys to identify the characteristics associated with retirement villages that influence relocation decisions. RESULTS: The provision of outdoor living areas, support in maintaining independence, assisted living facilities and accessibility to medical facilities were identified as factors that would encourage relocation. Luxury services (e.g. heated swimming pools) were indicated as least likely to encourage relocation. Negative perceptions most influential in discouraging relocation reflected a fear of losing independence and privacy. CONCLUSIONS: Through identifying the expectations of prospective residents, retirement village providers may better tailor facilities to the needs of their target demographic.

Considering relocation to a retirement village: predictors from a community sample.

AIM: To identify characteristics distinguishing older adults who have considered relocation to a retirement village in the future from those who have not. METHOD: Community-living residents (n = 517), aged 55 to 94, randomly selected from the Australian Capital Territory completed a postal survey. RESULTS: Consistent with prior research, the majority of respondents had not considered relocation to a retirement village. Retired persons, those aged 55-64 years, and persons reporting sufficient financial resources, poorer physical health and poorer current neighbourhood cohesion were most likely to have considered future relocation. CONCLUSIONS: The identification of factors characterising older adults seeking retirement village housing in the future is important in developing an understanding of the needs and expectations of the older population, and may allow aged care providers to better target the development of services to population needs (e.g. health-care supports). Further investigation into the specific expectations of the 55-64 year cohort is required.

Normative data and longitudinal invariance of the Life Engagement Test (LET) in a community sample of older adults.

PURPOSE: Interest in evaluating purpose in life as an important component of ageing well is growing; however, investigation into the appropriate measurement of this construct is required. The purpose of this paper was to examine the measurement properties of the Life Engagement Test (LET) and to provide normative data for a non-clinical sample of community-dwelling older adults. METHODS: A random sample of 545 adults, aged 55-94 years, completed the LET twice over a 12-month period as part of a larger survey on relocation in later life. RESULTS: Consistent with previous research, participants typically reported high levels of purpose in life. Scores were also observed to vary over the 12-month duration, with, on average, an increase in purpose in life at Time 2. However, tests of longitudinal invariance were inconclusive. CONCLUSIONS: Future research is needed to further examine the content validity of the LET, and its factorial invariance over longer measurement intervals, and across different populations including non-residential/aged care settings.

Unmet depression information needs in the community.

BACKGROUND: Despite the well acknowledged importance of consumer health information, little is known about the public's depression information needs. This study aimed to develop a formal measure of unmet need for depression information in the community, to investigate the level of this unmet need and to identify its predictors. METHODS: Data were collected as part of a survey of 12,319 Australian adults aged 18-65 years. This survey incorporated 21 questions targeting depression information need, together with measures of demographic status, self-reported current depression and personal stigma. The information needs data were subjected to principal components analysis followed by linear regression analyses to determine the demographic and other predictors of each of the resulting components. RESULTS: Between 50 and 75% of participants endorsed the need for more information on each of the 21 information need topics. The PCA yielded a 20-item Depression Information Needs Scale (DINS) of high reliability and factor validity comprising four subscales: General (facts about depression), Specific Treatments, Research and Policies, and Lived Experience. Controlling for other factors, those with self-reported current depression and those without tertiary education had greater information needs across all four factors. LIMITATIONS: The survey response rate was low and further research is required to establish the adequacy of the psychometric properties of the DINS. CONCLUSIONS: Given the high unmet need for depression information there is a need to develop and implement evidence-based strategies for ensuring the accessibility and uptake of depression information relevant to the needs of members of the community.

Can positive social exchanges buffer the detrimental effects of negative social exchanges? Age and gender differences.

BACKGROUND: Findings from existing research exploring whether positive social exchanges can help to offset (or 'buffer' against) the harmful effects of negative social exchanges on mental health have been inconsistent. This could be because the existing research is characterized by different approaches to studying various contexts of 'cross-domain' and 'within-domain' buffering, and/or because the nature of buffering effects varies according to sociodemographic characteristics that underlie different aspects of social network structure and function. OBJECTIVE: The purpose of this study was to examine whether the buffering effects of global perceptions of positive exchanges on the link between global negative exchanges and mental health varied as a function of age and gender. METHOD: We used a series of regressions in a sample of 556 Australian older adults (ages 55-94) to test for three-way interactions among gender, positive social exchanges, and negative social exchanges, as well as age and positive and negative social exchanges, in predicting mental health, controlling for years of education, partner status, and physical functioning. RESULTS: We found that positive exchanges buffered against negative exchanges for younger old adults, but not for older old adults, and for women, but not for men. CONCLUSIONS: Our findings are interpreted in light of research on individual differences in coping responses and interpersonal goals among late middle-aged and older adults. Our findings are in line with gerontological theories (e.g., socioemotional selectivity theory), and imply that an intervention aimed at using positive social exchanges as a means of coping with negative social exchanges might be more successful among particular populations (i.e., women, 'younger' old adults).

Volunteering and subjective well-being in midlife and older adults: the role of supportive social networks.

OBJECTIVE: This study examined the extent to which associations between volunteering and subjective well-being (SWB) could be related to volunteers having more supportive social networks relative to nonvolunteers. METHOD: The sample consisted of 561 midlife and older adults (aged 55-94 years) from the TRAnsitions In Later Life study. Multiple mediation analyses examined associations between hours spent volunteering per week; availability of social support from friends, relatives, and neighbors; positive and negative social exchanges; and SWB. RESULTS: The results indicated that the higher life satisfaction and positive affect reported by those who volunteer at moderate levels (up to 7 hr per week) are related to their higher levels of positive social exchanges and greater availability of social support from friends and family, relative to nonvolunteers. Those who volunteer at higher levels (7 hr or more per week) also reported greater levels of positive affect in comparison to nonvolunteers, and this was related to their greater availability of social support from friends. Availability of support from friends accounted for the greatest proportion of the volunteering-SWB associations. DISCUSSION: The findings suggest that the positive SWB associated with volunteering is related to volunteers' more extensive friend and family networks.

The effectiveness of an online support group for members of the community with depression: a randomised controlled trial.

BACKGROUND: Internet support groups (ISGs) are popular, particularly among people with depression, but there is little high quality evidence concerning their effectiveness. AIM: The study aimed to evaluate the efficacy of an ISG for reducing depressive symptoms among community members when used alone and in combination with an automated Internet-based psychotherapy training program. METHOD: Volunteers with elevated psychological distress were identified using a community-based screening postal survey. Participants were randomised to one of four 12-week conditions: depression Internet Support Group (ISG), automated depression Internet Training Program (ITP), combination of the two (ITP+ISG), or a control website with delayed access to e-couch at 6 months. Assessments were conducted at baseline, post-intervention, 6 and 12 months. RESULTS: There was no change in depressive symptoms relative to control after 3 months of exposure to the ISG. However, both the ISG alone and the combined ISG+ITP group showed significantly greater reduction in depressive symptoms at 6 and 12 months follow-up than the control group. The ITP program was effective relative to control at post-intervention but not at 6 months. CONCLUSIONS: ISGs for depression are promising and warrant further empirical investigation. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN65657330.

Personal and neighborhood resources, future time perspective, and social relations in middle and older adulthood.

OBJECTIVES: Aging-related changes in motivation and the availability of resources have been hypothesized to result in social network changes in later life. However, few studies have examined associations of both motivation and resources with different aspects of social network composition in the same analytical context. The present study examined associations of key motivational (future time perspective [FTP]) and resource variables (partner status, physical health, and perceived neighborhood cohesion) with social network size and positive and negative social exchanges. METHOD: A population-based sample of midlife (aged 55-59 years, n = 169) young-old (aged 60-74 years, n = 306) and old-old (aged 75+ years, n = 77) adults completed a questionnaire. RESULTS: Those who were partnered reported larger networks with family, whereas never-married individuals reported larger networks with neighbors. Perceived neighborhood cohesion was related to larger networks with family, neighbors, and friends. Open-ended FTP was associated with larger networks of friends and more frequent positive social exchanges. DISCUSSION: Our results point to FTP and resources having different implications for social engagement across network domains.