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Annotated bibliography: Screen time and its impact on young people’s mental health.

 

Babic, M. J., Morgan, P. J., Plotnikoff, R. C., Lonsdale, C., & Eather, N. (2015). Skinner, Geoff; Baker, Amanda L.; Pollock, Emma; Lubans, David R. “Rationale and study protocol for ‘Switch-off 4 Healthy Minds'(S4HM): a cluster randomized controlled trial to reduce recreational screen time in adolescents”. Originally published in Contemporary Clinical Trials Vol. 40, p. 150-158 (2015). Clinical Trials, 40, 150-158.

This paper describes a school-based strategy trialled in New South Wales to reduce screen time for adolescents in response to the known adverse effects high screen time can have on their mental and physical health. It uses self-determination theory and involves educating both the adolescent and their parents. Prompts were sent to the young via the social media platform of their choice and newsletters were sent to parents to raise awareness of screen time and its dangers. There wasn’t much detail in the paper about the interventions that would be employed in implementing the strategy.

Chassiakos, Y. L. R., Radesky, J., Christakis, D., Moreno, M. A., & Cross, C. (2016). Children and adolescents and digital media. Pediatrics, 138(5), e20162593.

This report provides a summary of the benefits and risks of childhood exposure to digital media. Social media can have beneficial effects to the mental health of LGBTIQ teenagers if they use it to engage with supportive communities. Similarly, individuals with mental illness may also benefit when using social media to share stories with others experiencing similar challenges. However, this can also leave them open to exposure, misinformation, negativity and hostility. Examples of digital media which may have adverse effects on the mental health of young people are pro-anorexia sites. Exposure to risky behaviour in media has been proven to increase teenage uptake of the behaviour and this exposure can be difficult to police on digital devices by parents. Social media has been shown to have both positive and negative effects on young people’s mental health. Used in moderation it can enhance their feelings of social connectedness. Passive use of social media or following attractive celebrities can increase depression and lower self-esteem, whereas engaging actively with family and friends has the opposite effect.

Gunnell, K. E., Flament, M. F., Buchholz, A., Henderson, K. A., Obeid, N., Schubert, N., & Goldfield, G. S. (2016). Examining the bidirectional relationship between physical activity, screen time, and symptoms of anxiety and depression over time during adolescence. Preventive Medicine, 88, 147-152.

This study was performed to establish relationships between low levels of physical activity, high screen time, depression and anxiety in adolescents. It took place over 11 years and took the form of four time specific questionnaires covering the ages from 10-21 years old (n= 1160, mean age = 13.54 years).  The results were controlled for variables such as gender, ethnicity, location and educational level of parents. A decrease in physical activity and increase in screen time, depression and anxiety over time was observed. Initial high anxiety was associated with higher screen time and lower physical activity independent of symptoms of depression. Higher initial levels of depression were also associated with higher screen time and predicted greater decreases in physical activity over time.  Limitations include the data collected was self-reported, type of screen time and type of physical activity was not identified and there was a high rate of attrition.

Hoare, E., Milton, K., Foster, C., & Allender, S. (2016). The associations between sedentary behaviour and mental health among adolescents: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 108.

This systematic review examined 32 papers, all of which reported the use of screen time for leisure amongst adolescents and two thirds identified depressive symptoms. Adolescence is a significant risk period for the development of mental health disorders and it is also a period when lifestyle behaviours are developed which can impact on mental health into adulthood. Depressive symptoms and length of  screen time for leisure use were consistently linked in the evidence. There was moderate evidence for an association between length of screen time and low self-esteem. More than 2-3 hours of screen time per day in adolescents is linked to poorer mental health status. It identified that the link may be in part due to the sedentary nature of screen time, as physical activity has been found to have a positive effect on mental health. Adolescents with poor mental health may lack motivation to exercise and instead opt for screen based activities. Young people who lead sedentary lifestyles are more likely to suffer from obesity, which can lead to stigmatisation and bullying resulting in adverse effects on their mental health.

Maras, D., Flament, M. F., Murray, M., Buchholz, A., Henderson, K. A., Obeid, N., & Goldfield, G. S. (2015). Screen time is associated with depression and anxiety in Canadian youth. Preventive Medicine, 73, 133-138.

Increased screen time has been linked to low physical activity and obesity in youth, factors that have been linked to an increase in depression and anxiety. The study aimed to examine the relationship between length of screen time and anxiety and depression in young people using a large community sample of Canadian adolescents (n=2482). They found that depression was associated with any type of screen behaviour except watching the TV, whereas anxiety was only associated with gaming. This is consistent with other large-scale studies including studies from the USA and Australia. They offer several explanations for this including social isolation and cyberbullying.  A limitation of the study was that they couldn’t conclude whether it was increased screen time that caused the depression and anxiety or whether the opposite was true that people with depression and anxiety spent more time on their electronic devices.

Przybylski, A. K., & Weinstein, N. (2017). A large-scale test of the Goldilocks Hypothesis: Quantifying the relations between digital-screen use and the mental well-being of adolescents. Psychological Science, 28(2), 204-215.

This study tested the Goldilocks Hypothesis for screen time in adolescents to try and ascertain the optimum amount of screen time that would benefit development without adversely affecting mental health. They studied 120115 British adolescents. They found the relationship between screen time and mental health was non-linear and a moderate time spent on screens was not harmful and may even have positive effects on wellbeing. There were differences in effect depending on the screen type, the type of activity, the day or time used and the level of engagement in the activity. They recommend studying the functionality of screen time against other daily pursuits in order to get a fuller understanding. Overall they concluded that moderate technology use was not intrinsically harmful and may prove beneficial in an increasingly digital world.

Saquib, N., Saquib, J., Wahid, A., Ahmed, A. A., Dhuhayr, H. E., Zaghloul, M. S., … & Al-Mazrou, A. (2017). Video game addiction and psychological distress among expatriate adolescents in Saudi Arabia. Addictive Behaviors Reports, 6, 112-117.

This study was conducted using a self-reported survey distributed to 276 students in expatriate schools in Saudi Arabia. The researchers use DSM-V criteria to diagnosed video game addiction and it was compared with other variables including screen time and psychological distress. The mean age of the participants was 15.3 years and nearly 75% reported screen time greater than 2 hours and 20% reported sleeping less than 5 hours a night. Those addicted to video games encompassed 15.8% of the sample and they were more likely to be boys, have higher screen time and less sleep. Addiction to video games was strongly related to psychological distress, as was screen time greater than 2 hours a day.  Psychological distress was also related to gender, with girls being more likely to experience it and inversely to sleep patterns. This study didn’t find any link between physical activity or BMI and psychological distress. The study concludes that screen time has an independent association with psychological distress even when other variables are taken into consideration.

Straatmann, V. S., Oliveira, A. J., Rostila, M., & Lopes, C. S. (2016). Changes in physical activity and screen time related to psychological well-being in early adolescence: findings from longitudinal study ELANA. BMC Public Health, 16(1), 977.

In this study, data was analysed from 526 adolescents in Brazil, assessing physical activity, screen time and psychological distress using a questionnaire. Psychological distress was associated with exceeding the recommended screen time of 4 hours per day in girls, although they questioned whether there was a negative causality impacting on this that is the psychological distress caused them to withdraw and spend more time on screen based activities. For boys, psychological distress was associated with a reduction in physical activity in this study. The study was limited in that the data collected was self-reported.

Trinh, L., Wong, B., & Faulkner, G. E. (2015). The independent and interactive associations of screen time and physical activity on mental health, school connectedness and academic achievement among a population-based sample of youth. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 24(1), 17.

The study aimed to establish the effects high screen time and physical activity had independently and together on the mental health of young people. Data was collected from 2660 adolescents using a survey. It found that high screen time is consistently associated with poorer mental health independent of the amount of physical activity. However, there may be reverse causality where depressed youth seek social isolation or comfort in their digital devices. The study also found that high screen time was associated with low self-esteem, which did not improve with physical activity.  Higher screen time was associated with lower physical activity. It concluded that screen time and physical activity had both independent and interactive effects on the mental health of young people. A limitation in the study was that the data was self-reported.

Twenge, J. M., Joiner, T. E., Rogers, M. L., & Martin, G. N. (2017). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 2167702617723376.

There was an increase in teenage depression and suicide in the USA between 2010 and 2015, which corresponded with the increased use of smartphones and other digital devices. This study analysed the data from two national surveys of high school students in the USA to establish if there was a link between screen time and depression and suicide.  There were 388275 respondents to the surveys, who completed them retrospectively. The study found a positive correlation between screen time and depression and suicide especially amongst females. No significant variation occurred in other variables such as socioeconomic status. Exercise and face-to-face social interaction negatively correlated with depression and suicide, but increased screen time was often associated with low physical activity and social interaction. Lack of sleep has also been identified in other studies as being linked to increased screen time and as a risk factor for depression and suicide. The study was unable to establish if screen time was the sole cause of increased incidence of depression and suicide, the joint cause or if the cause was one of the other factors. Another limitation was the surveys were completed retrospectively rather than in real time, which may have affected the answers given.

Wu, X., Tao, S., Zhang, Y., Zhang, S., & Tao, F. (2015). Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students. PLoS One, 10(3), e0119607.

High screen time and low physical activity have been shown to interact to cause psychological problems. The study has suggested that high screen time is associated with a higher incidence of depression, anxiety, psychopathological symptoms and poor sleep quality. It is also associated with reduced physical activity. Physical activity has been shown to reduce symptoms of depression, anxiety and other mental health problems. The results of this study suggest that high screen time and low physical activity both increase psychological stress independently and synergistically. A limitation of the study is that it assessed self-reported symptoms and not clinically diagnosed disorders.

Wu, X., Tao, S., Zhang, S., Zhang, Y., Chen, K., Yang, Y., … & Tao, F. (2016). Impact of screen time on mental health problems progression in youth: a 1-year follow-up study. BMJ Open, 6(11), e011533.

This study examined the association between screen time and mental health in a group of Chinese university students (n=2521, mean age=18.43 years). Nearly all of the participants reported screen time of more than 2 hours per day. They found consistent associations with screen time and anxiety, depression or other psychopathology. The associations also remained after adjustments for other variables. Due to the small effects size it is unclear to what degree screen time effects mental health outcomes. The limitations of the study include that the data collected was self-reported and it doesn’t differentiate between different screen uses.

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May PD

You can add to the professional development post by commenting below or emailing the library.

Online resources

Read – professional reading

Available from the library database

Geerlings, L. R., Thompson, C. L., Bouma, R., & Hawkins, R. (2018). Cultural Competence in Clinical Psychology Training: A Qualitative Investigation of Student and Academic Experiences. Australian Psychologist, 53(2), 161-170.

Massey, S. H., Newmark, R. L., & Wakschlag, L. S. (2018). Explicating the role of empathic processes in substance use disorders: A conceptual framework and research agenda. Drug And Alcohol Review, 37(3), 316-332.

Rychert, M., Wilkins, C., Parker, K., & Witten, K. (2018). Are government‐approved products containing new psychoactive substances perceived to be safer and more socially acceptable than alcohol, tobacco and illegal drugs? Findings from a survey of police arrestees in New Zealand. Drug And Alcohol Review, 37(3), 406-413.

Torgerson, C. N., Love, H. A., & Vennum, A. (2018). The buffering effect of belonging on the negative association of childhood trauma with adult mental health and risky alcohol use. Journal of Substance Abuse Treatment, 88, 44-50.

Wendt, D. C., & Gone, J. P. (2018). Complexities with group therapy facilitation in substance use disorder specialty treatment settings. Journal Of Substance Abuse Treatment, 88(1), 9-17.

Open Access Articles

Dembo, R., Faber, J., Cristiano, J., Wareham, J., Krupa, J. M., Schmeidler, J., & Terminello, A. (2018). Family Problems, Mental Health and Trauma Experiences of Justice-Involved Youth. Medical Research Archives, 6(1).

Maremmani, A. G., Maiello, M., Carbone, M. G., Pallucchini, A., Brizzi, F., Belcari, I., … & Maremmani, I. (2018). Towards a psychopathology specific to Substance Use Disorder: Should emotional responses to life events be included?. Comprehensive psychiatry, 80, 132-139.

Olney, S. (2018). Should Love Conquer Evidence in Policy‐Making? Challenges in Implementing Random Drug‐Testing of Welfare Recipients in Australia. Australian Journal of Public Administration, 77(1), 114-119.

Rossen, I., Pettigrew, S., Jongenelis, M., Stafford, J., Wakefield, M., and Chikritzhs, T. (2017). Evidence on the nature and extent of alcohol promotion and the consequences for young people’s alcohol consumption. Report prepared for the Mental Health Commission by the WA Cancer Prevention Research Unit, Curtin University School of Psychology and Speech Pathology, Perth, Western Australia.

Wiktorsson, S., Rydberg Sterner, T., Mellqvist Fässberg, M., Skoog, I., Ingeborg Berg, A., Duberstein, P., … & Waern, M. (2018). Few Sex Differences in Hospitalized Suicide Attempters Aged 70 and Above. International journal of environmental research and public health, 15(1), 141.

Open access online journal

NADA Advocate: published 4 times a years raises issues in the NSW non-government AOD sector

Open access textbooks

Lawrence, R.J. (2016). Professional Social Work in Australia

Useful resources

Language does it matter?

Produced by NADA and intended for the AOD sector, this resource provides best practice guidelines on the use of language to empower clients.

Inroads program:

Researchers from UNSW and Macquarie University developed the inroads program for young adults with concerns about their anxiety and drinking.

Over five online modules, the program will help the participant develop new skills to encourage them to think about their use of alcohol and overcome anxiety. They will be encouraged to set goals and stick to their choices. The modules are completed weekly and they will also receive phone/ email support from an experienced psychologist (copied from Inroads website)

Drug and Alcohol Research Connections Newsletter:

A joint publication of the collaborative network of alcohol and other drug research centres; National Drug and Alcohol Research Centre (NDARC) at UNSW; National Drug Research Institute (NDRI) at Curtin University; and National Centre for Education and Training on Addiction (NCETA) at Flinders University

NIDA Notes:

A monthly newsletter about drug abuse research. Articles this month include:

Long term marijuana use is associated with health problems in later life

Stressful experiences affect likelihood of remission of drug dependence, continued drug use and relapse

Substance use disorders are associated with major medical illnesses and mortality risk in a large integrated health care system

e-Book of the month

Karter, E. (2013). Women and Problem Gambling : Therapeutic Insights Into Understanding Addiction and Treatment. New York: Routledge.

Addiction is much misunderstood. Women and addictive gambling even more so, and for many years women have suffered in silence. This book explores how lonely, troubled lives and damaging relationships lead to the trap of problem gambling, the anxiety and chaos whilst locked inside, and then offers realistic hope of a way out. With the significant increase in women gambling problematically, Women and Problem Gambling aims to answer the often asked question who is to blame. The text covers: the role of the gambling industry the role of society women’s relationships with others and themselves what hitting rock bottom truly is. Case studies illustrate how gambling begins as harmless escapism and how stressful and sometimes painful lives, combined with spiralling debts, lead to desperation to avoid thoughts, feelings and the reality of life in chaos. Women can, and do, stop gambling, and the author shares anecdotes from patients, and discusses therapeutic models and practical strategies to demonstrate how this is possible. Women and Problem Gambling is based on the author’s research and theories developed throughout her extensive practice. The insights will be of value to anyone wanting to understand or work with problem gambling in women; from a woman with a problem herself, thorough to family, friends and any healthcare professionals or therapists involved in her care and treatment. (Description from EBSCO)

Free to download for all HOA staff from the library catalogue on work computers

Attend – informal learning sessions, journal club, seminar series

Insight Queensland

Free training sessions at Biala Community Health Centre in Brisbane, unless otherwise specified including:

More information and to register here

Online induction modules are a prerequisite to some of the courses. To access and download them visit http://www.insightqld.org/

 

LGBTIQ+ inclusive practice training for the AOD sector

Attend – conferences 

MyPHN Conference 2018

1-2 September, Mackay Entertainment and Convention Centre

Hosted by North Queensland Primary Health Network, this conference will bring together professionals from many streams to discuss ways to work together to improve services and outcomes

Registration $200-225

The Walk on the Wild Side (WOWS) Symposium is a one day annual convention held for people working in the AOD sector

11 May 2018, Royal Brisbane and Women’s Hospital.

Registration: $100-150

Write – presentations and papers

MyPHN Conference

Research findings and innovative new ideas which can inform policy, directly influence practice, inspire future research, health reform and add to the Primary Health Care (PHC) evidence base. As a contribution to fostering this impact, the Call for Abstracts asks authors to consider the contribution their work makes to policy, practice and/or research.

You can submit an abstract for the following:

• 15 minute concurrent poster presentation (10 minute presentation/5 minute Q&A)

• 20 minute concurrent plenary session

The Program Committee invites authors to submit abstracts for presentation within the program of MyPHN 2018. Submissions are sought for oral and poster presentations and can be made via the Abstract Submission Portal.

All abstracts must follow the abstract template and be submitted online by 14 June 2018. Please note that the closing date for abstract submissions will not be extended. (copied from MyPHN)

Listen – podcasts, webinars

Managing the physical health of people with co-occurring mental and substance use disorders

Insight webinars:

All at 10:00 AEST

Insight presentation recordings available now on YouTube

Assessed learning – short courses, certificates, diplomas, bachelors, post-grad

Electronic tools for use in the continuum of care for patients with addictions

This is a self-paced online course (registration with IRETA required but is free) about the use of technology throughout the continuum of care for patients with addiction. The five sections will introduce you to five different electronic tools that can be used in prevention, treatment, and aftercare.

Through this training, discover new ways to screen for drug and alcohol use, learn how technology can support cognitive behavioural therapy, and become familiar with other relevant substance use research. (copied from IRETA website)

National comorbidity guidelines free online training and website

The training program consists of 10 training modules that can be completed in any order. Registrants can choose which modules to engage in based on interest and experience. Those wishing to receive a certificate of completion must complete all modules (in any order) and successfully complete all quizzes.

At the end of each module, registrants will be presented with a quiz. All questions must be answered correctly before the module is completed, but there is no limit to how many times the quiz can be taken. Incorrect answers will refer participants to relevant sections of the Guidelines website.

At the completion of all modules, training participants will receive a certificate of completion


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Annotated bibliography: Telephone counselling

Bassilios, B., Pirkis, J., King, K., Fletcher, J., Blashki, G., & Burgess, P. (2014). Evaluation of an Australian primary care telephone cognitive behavioural therapy pilot. Australian Journal of Primary Health, 20(1), 62.

This paper discusses a telephone-based cognitive behavioural therapy pilot project which was trialed from July 2008 to June 2010, using an Australian Government-funded primary mental health care program. Uptake, sociodemographic and clinical profile of consumers, precise nature of services delivered, and consumer outcome were all assessed using a web-based minimum datasets. Project officers and mental health professionals were interviewed to obtain details about the implementation of the pilot. In total, 548 general practitioners referred 908 consumers, who received 6607 sessions (33% via telephone) by 180 mental health professionals. Clients were mostly females with an average age of 37 years and had a diagnosis of depressive and/or anxiety disorders. Both telephone and face-to-face sessions of 60 minutes in length were run, delivering behavioural and cognitive therapy, often at no cost to clients. Several issues were identified by project officers and mental health professionals, during implementation. Face-to-face treatment is usually preferred by providers and clients, but having the option of telephone counselling is valued, especially for clients who would not otherwise access psychological services. Evidence from the positive client outcomes supports the practice of offering a choice of face-to-face or telephone counseling or a combination of the two. A limitation of this study was the absence of a non-treatment control group.

Best, D., Hall, K., Guthrie, A., Abbatangelo, M., Hunter, B., & Lubman, D. (2015). Development and implementation of a structured intervention for alcohol use disorders for telephone helpline services. Alcoholism Treatment Quarterly, 33(1), 118.

This article details a pilot study of a six-session intervention for harmful alcohol use via a 24-hour alcohol and other drug (AOD) helpline. It aimed to evaluate the viability of telephone-delivered intervention for AOD treatment. The intervention included practice features from motivational interviewing, cognitive behavioural therapy, and node-link mapping. It was evaluated using a case file audit (n=30) and a structured telephone interview a month after the final session (n=22). Psychological distress in the participants was significantly reduced and average scores on the Alcohol Use Disorders Identification Test (AUDIT) dropped by more than 50%. The results indicate that telephone intervention offers effective and efficient treatment for individuals with alcohol use disorders who are unable or unwilling to access face-to-face treatment.

Constant, H. M. R. M., Figueiró, L. R., Tatay, C. M., Signor, L., & Fernandes, S. (2016). Alcohol User Profile after a Brief Motivational Intervention in Telephone Follow-up: Evidence Based on Coping Strategies. Journal of Alcoholism and Drug Dependence, 4 (254), 2.

The benefits of intervention in alcohol abuse varies among individuals in particular with relapse. This research studied alcohol cessation in 120 people over a 6 month period and evaluated the effect of brief motivational interviewing. The study surveyed 120 participants over the phone using the Coping Behaviours Inventory as a measure. The study included a control group of 50 participants who did not receive any intervention. Almost all those who received telephone counselling had quit drinking alcohol at the 6 month period, whereas most of those in the control group did not stop drinking alcohol. The study suggests this may be due to motivation to change and social support. A longer term study was recommended.

Gates, P. (2015). The effectiveness of helplines for the treatment of alcohol and illicit substance use. Journal of Telemedicine and Telecare, 21(1), 18.

While tobacco helplines or quitlines are thought to be effective, there is limited evidence on the effectiveness of helplines which treat other substance use. This study reviewed literature on illicit drug or alcohol (IDA) helplines to address this gap. Five databases were searched for literature published in English, which involved the use of a telephone counselling helpline for the treatment of illicit drug or alcohol use. The author excluded review papers, opinion pieces, letters or editorials, case studies, published abstracts and posters. The initial search identified 2178 articles which were reduced to 36 articles after removing duplicates and those meeting the exclusion criteria. Descriptive information was provided in 29 articles about 19 different IDA helplines internationally. Call rates in these services varied from 3.7 to over 23,000 calls per month. Evaluative information was found in nine articles covering eight different IDA helplines, four articles described an evaluation of treatment outcomes against a control group and five articles contained details on treatment satisfaction or service utilisation. The study indicates that there is evidence that these services are effective. The studies in the review had poor consistency in their measures with few using randomized control groups. Limitations included that the articles were not evaluated by two independent researchers and the authors of the articles were not contacted for further information.

Haregu, T. N., Chimeddamba, O., & Islam, M. R. (2015). Effectiveness of Telephone-Based Therapy in the Management of Depression: A Systematic Review and Meta-Analysis. SM Journal of Depression Research and Treatment, 1(2), 1006.

This review was conducted as a gap was identified in systematic reviews identifying the effectiveness of telephone-based therapy for the treatment of depression. A total of nine papers were identified as meeting the selection criteria and were reviewed by the authors. It concluded that telephone counselling delivered by experienced and trained therapists is effective in treating depression and it suggested it is more effective than face-to-face but further studies are recommended.

Heinemans, N., Toftgård, M., Damström-Thakker, K., & Galanti, M. R. (2014). An evaluation of long-term changes in alcohol use and alcohol problems among clients of the Swedish National Alcohol Helpline. Substance Abuse Treatment, Prevention, and Policy, 9(1), 22.

This study evaluated alcohol reduction and AUDIT scores in participants utilising a standalone telephone counselling service in the form of an alcohol hotline, employing trained counsellors. The data was collected by telephone survey from 191 participants at the first call and 12 months later. Change in AUDIT score was used as the primary outcome and the number of counselling sessions defined the exposure intensity. Most participants reduced their alcohol intake and AUDIT score in the year of the study and 50% reported better mental health. These figures were supported by other studies. They also cited a study which indicated that telephone counselling sessions with one face-to-face consultation had significantly better outcomes than face-to-face consultations alone.

Le Gresley, H., Darling, C., & Reddy, P. (2013). New South Wales rural and remote communities’ perception of mental health telephone support services. In 12th National Rural Health Conference, http://nrha. org. au/12nrhc/wpcontent/uploads/2013/06/Le-Gresley-Helen_ppr. pdf.

This study examined perceived barriers to telephone counseling in rural communities. The data was collected using surveys and there were 213 participants. Most of the participants felt it was a cost-cutting option which was not as effective as face-to-face counselling. Cost of accessing the services using a mobile phone was also quoted as being a barrier, as was being placed on hold or not getting through and having to repeat their story to different therapists. Poor marketing of the different services led to confusion on which was the best service to access.

Tse, S., Campbell, L., Rossen, F., Wang, C. W., Jull, A., Yan, E., & Jackson, A. (2013). Face-to-face and telephone counseling for problem gambling: A pragmatic multisite randomized study. Research on Social Work Practice, 23(1), 57.

This was a randomised study which aimed to compare the effectiveness of telephone and face-to-face counselling in treating problematic gambling. Psychological interventions were provided to 92 participants either by telephone or face-to-face over a 3 month period. Data was collected using surveys and questionnaires and significant changes were found over time in hours and money spent gambling and gambling beliefs. The study indicated that both face-to face and telephone counselling were equally effective in reducing problematic gambling. Limitations included the lack of a control group and the high rate of attrition of the participants, with only 27 completing the program.

Van Horn, D. H. A., Drapkin, M., Lynch, K. G., Rennert, L., Goodman, J. D., Thomas, T., … McKay, J. R. (2015). Treatment choices and subsequent attendance by substance-dependent patients who disengage from intensive outpatient treatment. Addiction Research and Theory, 23(5), 391.

This study examined continual engagement rates in alternative treatment options in patients who had previously disengaged from intensive outpatient programs (IOP). Alternatives included return to IOP, individual psychotherapy, telephone counselling, medication management and no treatment. Of the 96 people contacted 6 chose telephone counselling and there were no differences seen in engagement with any of the treatment options. The limitations included the very small sample size and that participants were contacted by a researcher with whom they had had no previous engagement and asked to select a treatment option.


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Annotated bibliography: Comorbidity

Bonevski, B., Regan, T., Paul, C., Baker, A. L., & Bisquera, A. (2014). Associations between alcohol, smoking, socioeconomic status and comorbidities: evidence from the 45 and Up Study. Drug and Alcohol Review, 33(2), 169-176.

This study aimed to examine if there were any links between mental illness and low socioeconomic status (SES) and concurrent tobacco and alcohol consumption. Data was obtained from the 45 and Up Study of 267153 adults aged over 45 in New South Wales, who completed a survey assessing alcohol, smoking, psychological distress, treatment for anxiety or depression and a range of SES factors. The research found strong links between low SES, treatment for anxiety or depression, psychological distress and concurrent tobacco smoking and alcohol misuse. It recommended a move away from the silo approach of addressing tobacco, alcohol and mental health, as it has proved ineffective in reducing the high smoking rates among people experiencing mental illness or seeking help for alcohol and other drug problems. It suggested a comprehensive and holistic approach was needed in treating these people. It also recommended more research to explore the potential for the community service sectors to provide treatment for people with multiple health and social concerns.

Brière, F. N., Rohde, P., Seeley, J. R., Klein, D., & Lewinsohn, P. M. (2014). Comorbidity between major depression and alcohol use disorder from adolescence to adulthood. Comprehensive Psychiatry, 55(3), 526-533.

The aim of this study was to examine the development of comorbidity between alcohol use disorder (AUD) and major depressive disorder (MDD). It focussed on the relationship between the disorders at different time periods in adolescence and young adulthood. Participants were interviewed at ages 16, 17, 24 and 30. There were 861 participants who were predominantly white and equally split between male and female. Comorbidity was found to be low in adolescence but increased in adulthood, with most individuals with one disorder having the other. The exception was women with MDD. Adolescents with AUD were at increased risk of developing MDD and young adults with MDD were more likely to develop AUD. People diagnosed with comorbidity of MDD and AUD had an increased risk of alcohol dependence, suicide attempts and life dissatisfaction than those diagnosed with either MDD or AUD. Lifetime rates of comorbid MDD and AUD were higher than in previous studies and the report recommended screening for the other disorder at regular intervals when an individual presented with either MDD or AUD.

Carter, M., Fisher, C., & Isaac, M. (2013). Recovery from comorbidity: depression or anxiety with alcohol misuse—a systematic and integrative supradisciplinary review and critical appraisal. SAGE Open, 3(4), 2158244013512133.

Comorbidity of mood and anxiety disorders with alcohol misuse is not unusual. The study conducted a systematic literature review across different disciplines and research methodologies. Inconsistencies were found in definitions and measurements in the literature reviewed. Little evidence was found to support treatment plans. Competing paradigms in mental illness and addiction pose a barrier to progress and consumers frequently fall between the gaps. Clinicians feel undertrained and may be judgmental or unrecognise comorbidity, particularly in high risk populations. It suggested a consideration of different combinations of comorbidity and other factors such as social support, housing and employment which are crucial to recovery. It also recommended a need to build on the limited evidence and generalisation that was available.

Debell, F., Fear, N. T., Head, M., Batt-Rawden, S., Greenberg, N., Wessely, S., & Goodwin, L. (2014). A systematic review of the comorbidity between PTSD and alcohol misuse. Social Psychiatry and Psychiatric Epidemiology, 49(9), 1401-1425.

This systematic review was performed to ascertain the prevalence of comorbidity of post-traumatic stress disorder (PTSD) and alcohol misuse and any associations between the conditions. The literature reviewed was limited to that published between 2007 and July 2012.   A total of 42 papers were included in the review, after reviewing 620 abstracts. The incidence of PTSD comorbid to alcohol misuse ranged from 2 to 63% and alcohol abuse comorbid to PTSD 9.8 to 61.3%, with most of the prevalence rates being greater than 10%. These results indicated a strong association between the disorders. Significant evidence was found for association between alcohol misuse and numbing symptoms and hyperarousal. The evidence from the review supports the need for screening comorbidity in individuals who are known to have PTSD or alcohol misuse.

Gorka, S. M., MacNamara, A., Aase, D. M., Proescher, E., Greenstein, J. E., Walters, R., … & Digangi, J. A. (2016). Impact of alcohol use disorder comorbidity on defensive reactivity to errors in veterans with posttraumatic stress disorder. Psychology of Addictive Behaviors, 30(7), 733.

Evidence suggests that people who suffer from both PTSD and alcohol use disorder (AUD) have a heightened defence reactivity. This then maintains both their drinking behaviours and their anxiety or hyperarousal symptoms. Few studies however, have established whether people with PTSD and AUD have greater defence reactivity than those with PTSD without AUD. The aim of this study was to test this hypothesis. Error–related negativity (ERN) was measured, which is increased in anxious individuals and is thought to reflect defence reactivity to errors. Participants consisted of 66 male military veterans who were split into three groups:

  1. Controls with no PTSD or AUD
  2. Those with PTSD and no AUD
  3. Those with both PTSD and AUD

Those from the third group exhibited heightened ERN, whereas those in the first and second groups did not. This suggests that PTSD with AUD is a unique subtype of PTSD, with the comorbidity of AUD enhancing the defence reactivity in people with PTSD. The limitations in the study include the group size and demographics.

Leventhal, A. M., & Zvolensky, M. J. (2015). Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion–smoking comorbidity. Psychological Bulletin, 141(1), 176.

The research on comorbidity between emotional disorders and cigarette smoking has centred on the symptoms of anxiety and depression rather than clinical and theoretical advancement. The researchers who performed this study hypothesized that emotional vulnerabilities or behavioural traits, which reflect maladaptive emotional responses link various depressive and anxiety disorders to smoking. They did a literature review on three emotional vulnerabilities implicated in smoking:

  1. Anhedonia (Anh.)
  2. Anxiety sensitivity (AS): fear of anxiety related sensations
  3. Distress tolerance (DT): ability to withstand distressing situations

They concluded that the three collectively form a foundation for multiple emotional disorders; amplify the anticipated and actual affect enhancing properties of smoking; promote progression towards the smoking pathway and therefore are promising targets for smoking intervention. They used the information collected to propose a model linking emotional psychopathology to smoking:

  • Anh. amplifies smoking’s actual and expected pleasurable effects
  • AS increases smoking’s anxiety reducing effects
  • Low DT increases smoking’s distress reducing effects.

Together these factors reinforce smoking for individuals suffering from emotional disorders, which increases their risk of smoking initiation, progression, maintenance, not stopping, avoidance and relapse. They conclude that the results can be used for clinical and scientific implications that can be expanded to other comorbidities.

Riga, D., Schmitz, L. J., Van Der Harst, J. E., Van Mourik, Y., Hoogendijk, W. J., Smit, A. B., … & Spijker, S. (2014). A sustained depressive state promotes a guanfacine reversible susceptibility to alcohol seeking in rats. Neuropsychopharmacology, 39(5), 1115-1124.

The reported rates of comorbidity between AUD and MDD are high, but preclinical models studying how primary depression affects secondary AUD are lacking. This results in inadequate testing of drug treatment. The authors combined social defeat-induced persistent stress (SDPS) with operant self-administration (SA) concepts to assess causality between the disorders. They used guanfacine, a drug used to reduce cravings in humans against SDPS-induced change of operant alcohol SA. They socially defeated and isolated rats for at least 9 weeks, during which time they assessed depressive symptomology. The rats were then exposed to 5 months of operant SA concept, studying acquisition, motivation, extinction and cue-induced reinstatement of alcohol seek. Then at 6 months they measured the effects of the drug on motivation and relapse. The SDPS rats demonstrated significant changes to social and cognitive behaviour several months after defeat and increased motivation to obtain alcohol. Guanfacine reduced the effects on motivation caused by SDPS. The authors state that their model mimics the symptomology of a sustained depressive state and resultant vulnerability to alcohol abuse and that SDPS is strongly associated with alcohol intake and relapse. They argue that the study indicated that guanfacine has potential as a new treatment for patients with MDD and AUD comorbidity, as it is effective in reducing the sensitivity to alcohol and alcohol-induced stimuli. The limitation to this study is that it was performed on rats so may not translate to humans.

Scott, C. K., Dennis, M. L., & Lurigio, A. J. (2015). Comorbidity among female detainees in drug treatment: an exploration of internalizing and externalizing disorders. Psychiatric Rehabilitation Journal, 38(1), 35.

This study examined the incidence and comorbidity of major psychiatric disorders in female prisoners who were participating in drug treatment programs in a large American prison. The Needs Inventory was used, which includes a large mixture of methods to capture demographics, psychological problems, substance use and drug treatment histories and their criminal thinking tendencies. Two hundred and fifty-three women participated in the study, who were then split into three groups: those with substance use disorders (SUD) but no psychiatric disorders (24%); those with one psychiatric disorder (34%) and those with both internalising and externalising comorbidities (42%). Over 75% of the participants had comorbid psychiatric disorders and SUD, which are linked to lower self-esteem, increased drug use severity and levels of criminal thinking. The authors concluded that female prisoners in drug treatment programs need interventions focussing on both criminal and psychiatric recidivism, both whilst in prison and in the post-release phase. Limitations in the study are that it is a female only study and results may differ in a male population, and it was limited to those in drug treatment.

Emmerik‐van Oortmerssen, K., Glind, G., Koeter, M. W., Allsop, S., Auriacombe, M., Barta, C., … & Casas, M. (2014). Psychiatric comorbidity in treatment‐seeking substance use disorder patients with and without attention deficit hyperactivity disorder: results of the IASP study. Addiction, 109(2), 262-272.

Previous studies have indicated the attention deficit hyperactive disorder (ADHD) is highly comorbid with SUD, and that both ADHD and SUD are associated with other comorbid conditions including mental health disorders. The studies show that the disorders both independently and together increase the risk of comorbidity with psychiatric disorders. The objective of the study was to examine comorbidity patterns in adults seeking treatment for SUD, with or without ADHD. Different subtypes of ADHD and comorbidity patterns were examined, along with differences in gender and primary substance of abuse. They focussed on MDD, current (hypo)manic episode (HME), antisocial personality disorder (ASPD) and borderline personality disorder (BPD). They screened 3558 people from 47 centres in 10 countries, with a final group of 1205 participants. They found that MDD, BPD, ASPD and HME were all more prevalent in participants with ADHD than those without. Both BPD and MDD had increased comorbidity when alcohol was the primary substance of abuse as opposed to drugs. Comorbidity differed between ADHD subtypes with increased MDD in the inattentive and combined subtypes, increased HME and APSD in the hyperactive/impulsive and combined subtypes and increased BPD in all subtypes. The incidence of at least one comorbid disorder was 75% in those with ADHD, compared to 37% in those without. They concluded that treatment-seeking SUD patients with ADHD are at a very high risk of developing psychiatric disorders. The limitations of the study include the data collected was all self-reported and standardised measurement tools were not used between the different centres.

All the articles except the first one are Open Access and can be read by clicking on their titles. The top one is available from our library database to all staff and volunteers at Healthy Options Australia.

 


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January Professional Development

You can add to the professional development post by commenting below or emailing the library.

Online resources

Webpage

Australian Indigenous HealthInfoNet contains useful resources about Indigenous health

Useful resources

Drug and Alcohol Research Connections. December 2017

NIDA Notes. The latest in NIDA drug abuse research

 Read – professional reading

Available from the library database

  • Gomes de Matos, E., Kraus, L., Hannemann, T., Soellner, R., & Piontek, D. (2017). Cross‐cultural variation in the association between family’s socioeconomic status and adolescent alcohol use. Drug and Alcohol Review, 36(6), 797-804.
  • Hallgren, K. A., Dembe, A., Pace, B. T., Imel, Z. E., Lee, C. M., & Atkins, D. C. (2018). Variability in motivational interviewing adherence across sessions, providers, sites, and research contexts. Journal of Substance Abuse Treatment, 84(1), 30-41.
  • Harris, N., Miles, D., Howard, E., Zuchowski, I., King, J., Dhephasadin Na Ayudhaya, P., & … Puthantharayil, G. (2017). International Student Exchange in Australian Social Work Education. Australian Social Work, 70(4), 429-440.
  • Laux, J. M., DuFresne, R., Dari, T., & Juhnke, G. A. (2017). Substance Use Assessment Instruments: 13 Years Later. Journal of Addictions & Offender Counseling, 38(2), 115-124.
  • Li, W. W., & Miller, D. J. (2017). The impact of coping and resilience on anxiety among older Australians. Australian Journal of Psychology, 69(4), 263-272.

Open Access Articles

Open Access Journal

NADA Advocate is published four times a year, raises significant issues relating to the NSW non-government alcohol and other drug sector, and develops knowledge about, and connections within the sector.

 e-Book of the month

Free to download for all HOA staff from the library catalogue on work computers

Reiter, M. D. (2015). Substance Abuse and the Family. New York, NY: Routledge.

Substance Abuse and the Family demonstrates what it means to view addiction through a systems lens by considering biology and genetics, family relationships, and larger systems. Throughout the text, Michael D. Reiter shows how to examine a person’s predilection to become addicted, his or her social environment around substance use, the functionality of his or her family, and various treatment options. Chapters are organized around two sections: Assessment and Treatment. The first section pays attention to how the family system organizes around substance use and abuse. Here family roles, culture, and other issues such as family violence and resilience are covered. Two chapters are also included on the neuroscience and genetics of addiction, with contributions from Jaime L. Tartar and Christina Gobin. There are also chapters on working with partial systems, using genograms, and working in a culturally-sensitive way (with contributions from Dalis Arismendi), with culture-specific consideration paid to African American, Hispanic and Latin American, Asian American, and Native American families. The second half of the book explores what a systems orientation means in practice and goes over self-help groups for individuals and families. An overview of the major family therapy theories is included, which examines intergenerational, experiential, communication approaches, strategic, systemic, and post-modern models. A separate chapter examines issues faced by both youth and adult children of alcoholics. Intended for undergraduate and graduate students, as well as beginning practitioners, this text is one of the most penetrating and in-depth examinations on the topic available.

(copied from EBSCO site)

Attend – informal learning sessions, journal club, seminar series

National comorbidity guidelines free online training and website

The training program consists of 10 training modules that can be completed in any order. Registrants can choose which modules to engage in based on interest and experience. Those wishing to receive a certificate of completion must complete all modules (in any order) and successfully complete all quizzes.

At the end of each module, registrants will be presented with a quiz. All questions must be answered correctly before the module is completed, but there is no limit to how many times the quiz can be taken. Incorrect answers will refer participants to relevant sections of the Guidelines website.

At the completion of all modules, training participants will receive a certificate of completion.

(copied from National Comorbidity website)

Journal club TBA

Attend – conferences 

The 2018 Australian and New Zealand Addiction Conference will be held on Monday 28 and Tuesday 29 May with optional workshops on Wednesday 30 May at QT Gold Coast.

The 4th annual conference will cover a broad range of topics including prevention, treatment, systematic responses, behaviours, mental health and harm reduction in relation to all types of addiction.  Emerging trends and the various addictive habits of alcohol and other drugs, gambling and the internet are also covered.

Early bird registration from $599-899.

Write – presentations and papers

NADA invites abstract submissions for oral papers, workshops, panel presentations and poster presentations for the 2018 NADA Conference: Exploring therapeutic interventions.

This is an opportunity for you to showcase your innovative practice and research addressing the diverse and complex needs of people accessing AOD services.

Download the Call for Abstracts – information flyer for further details.

Abstracts must be submitted by Wednesday 28 February 2018 at 5pm EST to conference@nada.org.au

The NADA Conference will be held on 7-8 June 2018 at Sheraton on the Park, Sydney.

(copied from NADA website)

Listen – podcasts, webinars

Insight presentation recordings available now on YouTube

The Struggle of Mental Health TED Playlist

People who have struggled with mental illness tell their stories in this series of 10 talks.

Assessed learning – short courses, certificates, diplomas, bachelors, post-grad

Tools for Hard Conversations

Date: 11 January 2018 Facilitator: Kath Reid Workshop Duration: 1 day Workshop Time: 09:30 — 16:30 Early Bird Rate: $220.00 for registration received by 25/12/2017 Fees: $240.00 including morning tea and lunch, statement of attendance and all associated material and handouts. Workshop Venue: Lighthouse Resources Upstairs Training Room, Kyabra Street RUNCORN, QLD. 4113

(copied from Lighthouse website)

Registration/more information


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Annotated bibliography: Mental health in rural and remote communties

Allen, J., Inder, K. J., Lewin, T. J., Attia, J., & Kelly, B. J. (2012). Social support and age influence distress outcomes differentially across urban, regional and remote Australia: an exploratory study. BMC Public Health, 12(1), 928.
The aim of this study was to examine whether increasing remoteness had any effect on psychological distress. 4219 people over 55 years were surveyed across New South Wales about their levels of social support, demographic details, remoteness and levels of psychological distress experienced. The report concluded that remoteness could reduce the levels of psychological distress associated with a lack of social support. This may be due to people living in remote areas having a higher level of self-sufficiency. The study was limited in that it only studied older people.
Blignault, I., Haswell, M., & Pulver, L. J. (2016). The value of partnerships: lessons from a multi‐site evaluation of a national social and emotional wellbeing program for Indigenous youth. Australian and New Zealand Journal of Public Health, 40(S1).
This study provides the results of a three-year evaluation of SAM our way- a program that aimed to improve the social and emotional wellbeing of Aboriginal and Torres Strait Islander living in remote and regional areas of Australia. Five out of the 14 sites were studied, selecting from diverse locations over several states and in depth case studies were performed. The best performing sites were those where strong local partnerships had been formed with the local Indigenous community. Several lessons were learned including the importance of program design and resourcing and ways of working. It was essential to build partnerships with the local community including training and engaging members and working consistently with them, taking things slowly. Evaluation is essential and needs to be built into the programs. Activities need to be engaging and, effective integrating with other programs and services.
Carey, T. A., Wakerman, J., Humphreys, J. S., Buykx, P., & Lindeman, M. (2013). What primary health care services should residents of rural and remote Australia be able to access? A systematic review of “core” primary health care services. BMC Health Services Research, 13(1), 178.
A systematic review was performed to address which primary healthcare services should be accessible to all Australians regardless of geography. It was done in response to the inequality in access to healthcare faced by those in remote and rural communities. It concluded that defining a list of core services was difficult but that they should be an appropriate fit for service and evidence-based. Policy makers, consumers, practitioners and researchers need to work together in developing them to ensure that they are affordable and accessible to all.
Inder, K. J., Handley, T. E., Fitzgerald, M., Lewin, T. J., Coleman, C., Perkins, D., & Kelly, B. J. (2012). Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia. BMC Public Health, 12(1), 586.
Excessive alcohol use has been cited as a problem in rural and remote Australia and this study aimed to examine the geographical variation in rates and the potential effects of socio-economic disadvantage, population change and remoteness from services in contributing to this disparity. A survey was performed on 1981 people randomly taken from the electoral role using the Australian Rural Mental Health Study. It found that gender, age, marital status and personality status were the biggest contributors to at risk alcohol use. Financial advantage and experiencing multiple recent adverse life events also contributed to increased alcohol use. Relatively few district-level factors were linked to increased alcohol consumption after controlling for other factors.
Inder, K. J., Handley, T. E., Johnston, A., Weaver, N., Coleman, C., Lewin, T. J., & Kelly, B. J. (2014). Determinants of suicidal ideation and suicide attempts: parallel cross-sectional analyses examining geographical location. BMC Psychiatry, 14(1), 208.
Suicide rates are consistently higher in rural than urban settings so this study aimed to examine if there were any differences in determinants of suicidal ideation and attempts between the areas. The main determinants were psychological distress and mental illness. Parallel cross-sectional analyses were performed using data from the 2007 National Survey of Mental Health and Wellbeing (n=8463) and the Australian Rural and Mental Health Study (n=634). The former was under representative of rural and remote participants and the latter was over representative. Geographical location was not found to be associated with suicidal ideation or attempt, but socio-economic factors were significantly associated with higher rates of suicidality. Access to lethal means and isolation, resulting in not being found quickly may also affect the rate of suicidality. It stressed the importance of developing and evaluating targeted evidence-based intervention strategies for at risk groups.
Morandini, J. S., Blaszczynski, A., Dar‐Nimrod, I., & Ross, M. W. (2015). Minority stress and community connectedness among gay, lesbian and bisexual Australians: a comparison of rural and metropolitan localities. Australian and New Zealand Journal of Public Health, 39(3), 260-266.
The aim of this study was to examine the impact of locality on minority stress experienced by lesbian, gay and bisexual (LGB) Australians. Increased stress and lack of community connectedness experienced by LGB individuals has been associated with increased depression, drug and alcohol use and suicidality. Data was collected by survey (n=1306) to assess minority stressors, connection with community and social isolation. The results were than analysed to assess the effect of locality on these stressors independent of gender, age, ethnicity, education and income. Those living in rural and remote areas and unexpectedly outer metropolitan areas experienced higher levels of stressors and high LGB disconnection than those living in inner metropolitan areas. Reluctance to disclose sexuality, including increased concealment of sexuality from friends and internalised homophobia in men were more common in rural and remote communities. This will put them at increased risk of psychiatric morbidity. It recommends health promotion in these communities that is aimed at reducing homophobia and discrimination and support services to assist those struggling with stigma and isolation.


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May e-book of the month

The Wiley Handbook of Anxiety Disorders by Emmelcamp, P.M.G. & Ehring, T. (2014)

This is a comprehensive book which provides an overview of management and classification of anxiety disorders. It is well organised and spilt into sections covering:

  • Classification
  • Etiology
  • Specific disorders
  • Special populations
  • Prevention
  • Clinical assesment
  • Treatment
  • Clinical management of specific disorders
  • Clinical management of comorbidity
  • Approaches to improve effectiveness
  • Agenda for future research

It’s a book that can be dipped in and out of as needed or be read as a whole to provide the reader with a solid background on anxiety and its treatment and management.

This e-book is available free to access for Healthy Options staff and volunteers from the library using the organisation’s computers.