Publications by authors named "Amanda Fitzgerald"

34 Publications

Measuring goal progress using the goal-based outcome measure in Jigsaw - A primary care youth mental health service.

Child Adolesc Ment Health 2021 Jun 27. Epub 2021 Jun 27.

School of Psychology, University College Dublin, Dublin 4, Ireland.

Background: Jigsaw is a primary care youth mental health service designed to increase access to and utilisation of mental health supports for 12- to 25-year-olds. Effectiveness in community youth mental health services is typically assessed using standardised instruments. The aim of this study was to examine the effectiveness of Jigsaw's brief intervention model of support using an idiographic tool, the goal-based outcome (GBO) measure. The study also aimed to explore the type of goals set by young people engaging with this service.

Method: The study sample consisted of a secondary dataset of 4839 young people aged 12-25 years (63.5% female, 36.5% male) who engaged with one of Jigsaw's 13 brief intervention services. Overall, 7366 goals set using the GBO were examined. Inductive thematic analysis was conducted to examine the type of goals set by young people, and inferential analyses were used to examine statistical and reliable changes in goal progress.

Results: The goals young people set focused on developing coping mechanisms and personal growth and managing interpersonal difficulties. Mean scores for progress towards goals improved significantly from pre- to postintervention. The reliable change index (RCI) indicated that change greater than 2.82 points represents reliable change on the GBO, with 78.6% of young people showing reliable improvement. Demographic characteristics did not impact goal progress.

Conclusion: These findings suggest Jigsaw's brief intervention model of support is effective in assisting young people reach their goals and that the GBO is a suitable measure for young people attending a community-based youth mental health service.
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http://dx.doi.org/10.1111/camh.12489DOI Listing
June 2021

A qualitative study on the multi-level process of resilience development for adults recovering from eating disorders.

J Eat Disord 2021 Jun 9;9(1):66. Epub 2021 Jun 9.

School of Psychology, University College Dublin, Dublin, Ireland.

Background: Resilience research to date has been criticised for its consideration of resilience as a personal trait instead of a process, and for identifying individual factors related to resilience with no consideration of the ecological context. The overall aim of the current study was to explore the multi-level process through which adults recovering from EDs develop resilience, from the perspectives of clients and clinicians. The objective of this research was to outline the stages involved in the process of developing resilience, which might help to inform families and services in how best to support adults with EDs during their recovery.

Method: Thirty participants (15 clients; 15 clinicians) took part in semi-structured interviews, and responded to questions relating to factors associated with resilience. Using an inductive approach, data were analysed using reflexive thematic analysis.

Results: The overarching theme which described the process of developing resilience was 'Bouncing back to being me', which involved three stages: 'Who am I without my ED?', 'My eating disorder does not define me', and 'I no longer need my eating disorder'. Twenty sub-themes were identified as being involved in this resilience process, thirteen of which required multi-level involvement.

Conclusion: This qualitative study provided a multi-level resilience framework for adults recovering from eating disorders, that is based on the experiences of adults with eating disorders and their treating clinicians. This framework provided empirical evidence that resilience is an ecological process involving an interaction between internal and external factors occurring between adults with eating disorder and their most immediate environments (i.e. family and social). Anorexia nervosa, bulimia nervosa and binge-eating disorder demonstrate high rates of symptom persistence across time and poor prognosis for a significant proportion of individuals affected by these disorders, including health complications and increased risk of mortality. Many researchers have attempted to explore how to improve recovery outcomes for this population. Eating disorder experts have emphasised the need to focus not only on the weight indicators and eating behaviours that sustain the eating disorder during recovery, but also on the psychological well-being of the person recovering. One way to achieve this is to focus on resilience, which was identified as a fundamental aspect of eating disorder recovery in previous research. This study conceptualises resilience as a dynamic process that is influenced not only at a personal level but also through the environment in which the person lives. This study gathered data from adults with eating disorders and their treating clinicians, to devise a framework for resilience development for adults recovering from eating disorders. The paper discussed ways in which these findings and the framework identified can be easily implemented in clinical practice to facilitate a better understanding of eating disorder resilience and to enhance recovery outcomes.
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http://dx.doi.org/10.1186/s40337-021-00422-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191215PMC
June 2021

Interpreting ambiguous emotional information: Convergence among interpretation bias measures and unique relations with depression severity.

J Clin Psychol 2021 Jun 8. Epub 2021 Jun 8.

School of Psychology, University College Dublin, Dublin, Ireland.

This study aimed to examine the convergence among interpretation bias measures and their associations with depressive symptom severity. Research into interpretation biases employs measures of interpretation bias interchangeably, however, little is known about the relationship between these measures. Participants (N = 82 unselected undergraduate students; 59 female) completed four computer-based interpretation bias tasks in a cross-sectional design study. Indirect measures, based on participants' reaction times, were not correlated with each other and had poor split-half reliability. Direct measures were more strongly correlated with depressive symptoms than indirect measures, but only the Scrambled Sentences Task explained a reliable unique portion of the variance in depressive symptoms. Interpretation bias tasks may not measure the same cognitive process and may differ in the extent to which they are a cognitive marker of depression-linked interpretation bias. These findings help to improve the measurement of and theory underlying interpretation bias and depressive symptoms.
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http://dx.doi.org/10.1002/jclp.23186DOI Listing
June 2021

Parents' information needs, treatment concerns, and psychological well-being when their child is diagnosed with adolescent idiopathic scoliosis: A systematic review.

Patient Educ Couns 2021 06 25;104(6):1347-1355. Epub 2020 Nov 25.

School of Psychology, University College Dublin, Belfield, Dublin, D04V1W8, Ireland.

Objective: We systematically reviewed the experiences of parents who have a child with adolescent idiopathic scoliosis in order to understand their needs and concerns related to their child's healthcare, and assist health professionals in supporting parents of this paediatric patient group.

Methods: A systematic search strategy identified eighteen relevant studies published between 2000 and 2020. Quality was assessed using the Mixed Methods Appraisal Tool and the literature was narratively synthesised.

Results: Three main themes were evident across the literature including information needs, treatment concerns, and psychological well-being. Studies predominantly focused on the surgical treatment of scoliosis.

Conclusion: Parents face challenges such as acquiring appropriate knowledge about scoliosis to participate in healthcare decisions and coping with their child undergoing invasive spinal surgery. Throughout this time, their psychological well-being can be negatively impacted. Considering parents' experiences and support needs throughout this anxiety-provoking time is an important step in delivering family-centered care and promoting better outcomes for paediatric patients.

Practice Implications: Providing parents with appropriate resources and addressing concerns around surgical complications, postoperative pain, and how they can best support their child before and after surgery, may alleviate some of the emotional burden that parents experience.
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http://dx.doi.org/10.1016/j.pec.2020.11.023DOI Listing
June 2021

Family-related non-abuse adverse life experiences occurring for adults diagnosed with eating disorders: a systematic review.

J Eat Disord 2020 22;8:36. Epub 2020 Jul 22.

School of Psychology, University College Dublin, Dublin, Ireland.

Background: Although previous reviews suggest a strong association between abuse and eating disorders, less is known about non-abuse adverse life experiences, such as parental mental illness or family discord, which occur frequently for this population. The aim of the current study was to identify family-related non-abuse adverse life experiences occurring for adults with eating disorders, and to establish whether they occur for people with anorexia nervosa, bulimia nervosa or binge-eating disorder more than the general population and other psychiatric populations.

Method: A systematic review of studies focusing on family-related non-abuse adverse life experiences and eating disorders was conducted in accordance with PRISMA guidelines. The search string was applied to four electronic databases including Psycinfo, PubMed/Medline, CINAHL Plus and EMBASE.

Results: Of the 26 studies selected for inclusion, six types of family-related non-abuse adverse life experiences were identified: adverse parenting style; family disharmony; loss of a family member, relative or close person; familial mental health issues; family comments about eating, or shape, weight and appearance; and family disruptions. Findings provided tentative evidence for eating disorder specific (i.e. parental demands and criticism) and non-specific (i.e. familial loss and family disruptions) non-abuse adversities, with findings also suggesting that those with bulimia nervosa and binge-eating disorder were more impacted by loss, family separations and negative parent-child interactions compared to those with anorexia nervosa.

Conclusions: This review provides a clear synthesis of previous findings relating to family-related non-abuse adverse life experiences and eating disorders in adults. Implications for trauma-informed care in clinical practice were discussed (e.g. considering the impact of past life events, understanding the function of ED behaviours, reducing the risk of potential re-traumatisation).
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http://dx.doi.org/10.1186/s40337-020-00311-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374817PMC
July 2020

Is there an app for that? A cluster randomised controlled trial of a mobile app-based mental health intervention.

Health Informatics J 2020 09 8;26(3):1538-1559. Epub 2019 Nov 8.

University College Dublin, Ireland.

Demand for the use of mobile apps in mental health interventions has grown in recent years, particularly among adolescents who experience elevated levels of distress. However, there is a scarcity of evidence for the effectiveness of these tools within this population. The aim of this study was to test the effectiveness of CopeSmart, a mental health mobile app, using a multicentre cluster randomised controlled trial design. Participants were 15-18-years-olds (N = 560) recruited from 10 schools randomly assigned to an intervention or control condition. Intervention participants used the app over a 4-week period. Multi-level modelling analyses revealed no significant changes in the intervention group from pre-test to post-test, when compared to the control group, in terms of emotional distress, well-being, emotional self-awareness or coping strategies. Findings suggest that a 4-week app-based intervention may not be enough to elicit intra-personal changes in mental health outcomes in a general adolescent population.
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http://dx.doi.org/10.1177/1460458219884195DOI Listing
September 2020

Systematic review of body image measures.

Body Image 2019 Sep 6;30:170-211. Epub 2019 Aug 6.

School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address:

This systematic review synthesizes and critically appraises measurement properties of influential body image measures. Eight measures that met the definition of an assessment of body image (i.e., an individual's cognitive or affective evaluation of their body or appearance with a positive or negative valence), and scored high on systematic expert priority ranking, were included. These measures were: the Body Appreciation Scale (original BAS and BAS-2), the Body Esteem Scale for Adolescents and Adults, the Body Shape Questionnaire, the Centre for Appearance Research Valence Scale, the Drive for Muscularity Scale, two subscales of the Eating Disorders Examination Questionnaire, one subscale of the Eating Disorder Inventory 3, and two subscales of the Multidimensional Body Relations Questionnaire. Articles assessing these scales' psychometric properties (N = 136) were evaluated for their methodological quality using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist, and a best evidence synthesis was performed. The results supported the majority of measures in terms of reliability and validity; however, suitability varied across populations, and some measurement properties were insufficiently evaluated. The measures are discussed in detail, including recommendations for their future use in research and clinical practice.
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http://dx.doi.org/10.1016/j.bodyim.2019.06.006DOI Listing
September 2019

Dissociable psychosocial profiles of adolescent substance users.

PLoS One 2018 30;13(8):e0202498. Epub 2018 Aug 30.

UCD School of Psychology, University College Dublin, Newman Building, Belfield, Dublin, Ireland.

Objective: Alcohol, tobacco and cannabis use in adolescence is associated with adverse outcomes. Characterizing adolescent substance misusers, however, is difficult due to the wide range of risk and protective factors linked to substance use. The aim of the present study was to examine the role of the Individual, Family, School, Peer, and Social Environment on alcohol (lifetime and risky), tobacco (risky only), and cannabis use (lifetime and riskiness).

Method: Data were analyzed from a national sample of 5,680 adolescents, capturing substance use behavior alongside risk and protective factors across Individual, Family, School, Peer and Social domains. We applied a sophisticated machine learning classifier to develop models of alcohol, tobacco and cannabis initiation and misuse.

Results: We found highly accurate (area under curve of receiver-operator-characteristic for out-of-sample performance was > .88) and replicable (over multiple iterations and in comparison with permuted outcomes) dissociable psychosocial profiles of alcohol, tobacco and cannabis use. Alongside common predictors (peer relations and externalizing behavior), dissociable risk and resilience factors were observed. Adolescent profiles of alcohol use were distinguished by the contribution of multiple domains. In contrast, tobacco use was characterized by a small number of individual variables, including female gender and poor perceived academic position. Cannabis use was differentiated by the distinct contribution of Individual risk factors, in particular male gender and feelings of anger. Differential associations were also evident, with the strength and direction of association differing substantially across substances.

Conclusion: This study indicates that the relationship between the environment and substance use is more complex than previously thought.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202498PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116932PMC
February 2019

An investigation of emotion recognition training to reduce symptoms of social anxiety in adolescence.

Psychiatry Res 2018 05 8;263:257-267. Epub 2018 Feb 8.

University College Dublin School of Psychology, Newman Building Belfield, Dublin 4 Dublin, Leinster Ireland. Electronic address:

This study aimed to examine the effect of emotion recognition training on social anxiety symptoms among adolescents, aged 15-18 years. The study included a screening session, which identified participants who scored above a cut-off on a self-report measure of social anxiety for enrolment into a randomized controlled trial (Clinical Trials ID: NCT02550379). Participants were randomized to an intervention condition designed to increase the perception of happiness over disgust in ambiguous facial expressions or a sham intervention control condition, and completed self-report measures of social anxiety, fear of negative evaluation, anxiety-related disorders, and depressive symptoms. The intervention group demonstrated a strong shift in the balance point at which they perceived happiness over disgust in ambiguous facial expressions. This increase in positive perception was not associated with any changes in the primary outcome of social anxiety; however, some evidence of improvement in symptomatology was observed on one of a number of secondary outcomes. Those in the intervention group had lower depression symptoms at 2-week follow-up, compared to those in the control group who received the sham intervention training. Potential reasons for why the shift in balance point measurement was not associated with a concurrent shift in symptoms of social anxiety are discussed.
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http://dx.doi.org/10.1016/j.psychres.2018.02.023DOI Listing
May 2018

Investigating the psychometric properties of the revised child anxiety and depression scale (RCADS) in a non-clinical sample of Irish adolescents.

J Ment Health 2019 Aug 15;28(4):345-356. Epub 2018 Feb 15.

a School of Psychology, Newman Building , University College Dublin , Belfield , Ireland , and.

: The psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS) have been established cross-culturally, yet psychometric evidence is lacking for an English-speaking European population. : This research sought to further cross-validate the measure in a non-clinical Irish adolescent sample, and to test for gender and age-based differential item functioning in depression and anxiety. : Participants were Irish second-level school students (= 345; 164 male; 12-18 years, =14.97, SD= 1.44). Confirmatory factor analysis for categorical data (confirmatory item factor analysis) and multiple-indicator multiple-cause (MIMIC) modelling to identify items displaying possible metric invariance were conducted. : A six-factor model fit the data well in both gender samples and both school cycles, as a proxy for age samples. Gender-based metric invariance for 5 of 47 items and age-based metric invariance for three items were identified. However, the magnitudes were small. Internal consistency and validity were also established. : While, a number of items demonstrated minor metric invariance, there was no evidence that they influenced overall scores meaningfully. The RCADS can reasonably be used without adjustment in male and female, younger and older, adolescent samples. Findings have implications for the use of the RCADS in an English-speaking European population.
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http://dx.doi.org/10.1080/09638237.2018.1437604DOI Listing
August 2019

Risky sex behaviours among college students: The psychosocial profile.

Early Interv Psychiatry 2018 12 13;12(6):1203-1212. Epub 2017 Dec 13.

School of Psychology, University College Dublin, Belfield, Ireland.

Aims: Risky sex behaviours among college students are a growing public health concern. However, few studies have profiled these behaviours using a large range of psychosocial correlates.

Methods: Participants were 6874 undergraduate and postgraduate students (64.7% female, age range 17-25 years, M = 20.43 years, SD = 1.86 years) drawn from 13 higher-level institutions in Ireland.

Results: Regarding prevalence, 75% of the sample report that they have been, or are currently sexually active. Of this sexually active cohort (n = 5111), 27.2% report early sexual initiation, 29.5% report 5 or more lifetime sexual partners and 12.1% report 2 or more sexual partners in the past 3 months. In addition, 47.7% of students report inconsistent condom use and 39.5% report inconsistent use of other contraceptive methods in the past 3 months. Using multivariate logistic regression analyses, significant correlates of risky sex behaviour are identified across 5 groups of psychosocial predictors (demographic, sexuality and relationships, substance use, mental well-being and personal resources). Differences between males and females and between different sexual orientations are highlighted.

Conclusions: Suggestions are made for sexual education and intervention programs to specifically target subgroups of the student population.
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http://dx.doi.org/10.1111/eip.12526DOI Listing
December 2018

Association between attention bias to threat and anxiety symptoms in children and adolescents.

Depress Anxiety 2018 03 6;35(3):229-238. Epub 2017 Dec 6.

School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.

Background: Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The aim of this report is to examine the association between threat bias and pediatric anxiety symptoms using standardized measures in a large, international, multi-site youth sample.

Methods: A total of 1,291 children and adolescents from seven research sites worldwide completed standardized attention bias assessment task (dot-probe task) and child anxiety symptoms measure (Screen for Child Anxiety Related Emotional Disorders). Using a dimensional approach to symptomatology, we conducted regression analyses predicting overall, and disorder-specific, anxiety symptoms severity, based on threat bias scores.

Results: Threat bias correlated positively with overall anxiety symptoms severity (ß = 0.078, P = .004). Furthermore, threat bias was positively associated specifically with social anxiety (ß = 0.072, P = .008) and school phobia (ß = 0.076, P = .006) symptoms severity, but not with panic, generalized anxiety, or separation anxiety symptoms. These associations were not moderated by age or gender.

Conclusions: These findings indicate associations between threat bias and pediatric anxiety symptoms, and suggest that vigilance to external threats manifests more prominently in symptoms of social anxiety and school phobia, regardless of age and gender. These findings point to the role of attention bias to threat in anxiety, with implications for translational clinical research. The significance of applying standardized methods in multi-site collaborations for overcoming challenges inherent to clinical research is discussed.
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http://dx.doi.org/10.1002/da.22706DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342553PMC
March 2018

The Relationship Between Perceived Family Support and Depressive Symptoms in Adolescence: What is the Moderating Role of Coping Strategies and Gender?

Community Ment Health J 2017 05 2;53(4):474-481. Epub 2017 Feb 2.

University College Dublin School of Psychology, Newman Building, Belfield, Dublin 4, Ireland.

This study examined the moderating role of gender and coping strategies in the relationship between perceived family support, self-esteem and depressive symptoms. Data were used from the My World Survey Second Level (MWS-SL), a national survey of mental health among 6062 young people aged 12-19 years. Conditional process analyses indicated that planned coping moderated the relationship between perceived family support and depressive symptoms for those engaging in low-moderate levels but not high levels of planned coping, and this moderating role was stronger for females than males. Avoidance coping was a moderator for those engaging in moderate-high but not low levels of avoidance coping, and gender also moderated this relationship. Support-focused coping only moderated the perceived family support/depressive symptoms relationship for females. Findings suggest that the strength of the relationship between perceived family support and depressive symptoms depends on level of engagement with a particular coping strategy, and this engagement is a consistently stronger moderator for females.
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http://dx.doi.org/10.1007/s10597-017-0087-xDOI Listing
May 2017

Ecological Momentary Assessment of Adolescent Problems, Coping Efficacy, and Mood States Using a Mobile Phone App: An Exploratory Study.

JMIR Ment Health 2016 Nov 29;3(4):e51. Epub 2016 Nov 29.

Youth Mental Health Lab, School of Psychology, University College Dublin, Dublin, Ireland.

Background: Mobile technologies have the potential to be used as innovative tools for conducting research on the mental health and well-being of young people. In particular, they have utility for carrying out ecological momentary assessment (EMA) research by capturing data from participants in real time as they go about their daily lives.

Objective: The aim of this study was to explore the utility of a mobile phone app as a means of collecting EMA data pertaining to mood, problems, and coping efficacy in a school-based sample of Irish young people.

Methods: The study included a total of 208 participants who were aged 15-18 years, 64% female (113/208), recruited from second-level schools in Ireland, and who downloaded the CopeSmart mobile phone app as part of a randomized controlled trial. On the app, participants initially responded to 5 single-item measures of key protective factors in youth mental health (formal help-seeking, informal help-seeking, sleep, exercise, and sense of belonging). They were then encouraged to use the app daily to input data relating to mood states (happiness, sadness, anger, stress, and worry), daily problems, and coping self-efficacy. The app automatically collected data pertaining to user engagement over the course of the 28-day intervention period. Students also completed pen and paper questionnaires containing standardized measures of emotional distress (Depression, Anxiety, and Stress Scale; DASS-21), well-being (World Health Organization Well-Being Index; WHO-5), and coping (Coping Strategies Inventory; CSI).

Results: On average the participants completed 18% (5/28) of daily ratings, and engagement levels did not differ across gender, age, school, socioeconomic status, ethnicity, or nationality. On a scale of 1 to 10, happiness was consistently the highest rated mood state (overall mean 6.56), and anger was consistently the lowest (overall mean 2.11). Pearson correlations revealed that average daily ratings of emotional states were associated with standardized measures of emotional distress (r=-.45, r=.51, r=.32, r=.41, r=.48) and well-being (r=.39, r =-.43, r=-.27, r=-.35, r=-.33) Inferential statistics indicated that single-item indicators of key protective factors were related to emotional distress, well-being, and average daily mood states, as measured by EMA ratings. Hierarchical regressions revealed that greater daily problems were associated with more negative daily mood ratings (all at the P<.001 level); however, when coping efficacy was taken into account, the relationship between problems and happiness, sadness, and anger became negligible.

Conclusions: While engagement with the app was low, overall the EMA data collected in this exploratory study appeared valid and provided useful insights into the relationships between daily problems, coping efficacy, and mood states. Future research should explore ways to increase engagement with EMA mobile phone apps in adolescent populations to maximize the amount of data captured by these tools.

Trial Registration: Clinicaltrials.gov NCT02265978; http://clinicaltrials.gov/ct2/show/NCT02265978 (Archived by WebCite at http://www.webcitation.org/6mMeYqseA).
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http://dx.doi.org/10.2196/mental.6361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5155083PMC
November 2016

Substance Misuse and Behavioral Adjustment Problems in Irish Adolescents: Examining Contextual Risk and Social Proximal Factors.

Subst Use Misuse 2016 11 11;51(13):1790-809. Epub 2016 Aug 11.

a School of Psychology, University College Dublin , Dublin , Ireland.

Background: Using an ecological perspective to examine the roles of contextual factors and proximal social processes, the current study examined problem behavior among adolescents.

Objective: The study examined how family, peer, and school processes mediate the relationship between cumulative contextual risk and problem behavior, and whether these mediating relationships are moderated by gender.

Method: Data were obtained from the My World Survey Second Level, a cross-sectional national survey assessing risk and protective factors of mental health among 6062 adolescents aged 12-19 years (M = 14.93, SD = 1.62). Using risk factors from socioeconomic, community, and family levels, a cumulative contextual risk index (CCRI) was created to identify adolescents at increased risk of problem behavior in Ireland. Conditional process analysis examined whether gender moderated the relationship between the CCRI and problem behaviors (alcohol behavior, poorer behavioral adjustment, and problematic substance use) as mediated by five proximal social variables, family cohesion, mother criticism, father criticism, peer connectedness, and school connectedness.

Results: Using Hayes' (2013) SPSS macro for conditional process analyses, with age as a covariate, gender was shown to moderate the mediated relationships between CCRI and problem behaviors, via mother criticism and peer connectedness. Of note, a positive association was observed between high peer connectedness and alcohol risk behavior, highlighting the need to examine additional aspects of peer context including group norms and peer pressure.

Conclusion: The study provides valuable and practical implications for informing research, interventions, and social policy at family, peer, and school levels.
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http://dx.doi.org/10.1080/10826084.2016.1197938DOI Listing
November 2016

Fit for Purpose, Psychometric Assessment of the Eating Attitudes Test-26 in an Irish Adolescent Sample.

Eat Behav 2016 12 21;23:52-57. Epub 2016 Jul 21.

UCD School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address:

The present study examined the psychometric properties of the Eating Attitudes Test-26 (EAT-26) in a sample of Irish adolescents (N=2444). Consistent with previous research, in adolescents, confirmatory factor analysis (CFA) failed to replicate the original three-factor structure of the EAT-26. Goodness-of-fit indices provided support for a recently published six-factor EAT-18 model. As the EAT-26 is typically used as a unitary measure by clinicians, a second-order factor model was investigated, which supported a general concept of eating problems. Convergent validity of the EAT-18 was assessed using the Eating Disorder Inventory-3 (EDI-3). Using the 90th percentile, a cut-off score of 13 was identified on the EAT-18 that discriminated between those indicative and non-indicative of disordered eating attitudes and behaviors. Findings suggest that the revised factor structures may be more suitable for the general adolescent population than the original three-factor EAT-26. Clinical implications of the EAT-18 and future research recommendations are addressed.
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http://dx.doi.org/10.1016/j.eatbeh.2016.07.006DOI Listing
December 2016

A randomized controlled trial of attention bias modification training for socially anxious adolescents.

Behav Res Ther 2016 09 23;84:1-8. Epub 2016 Jun 23.

UCD School of Psychology, University College Dublin, Newman Building, Belfield, Dublin 4, Ireland.

The current study aimed to examine the efficacy of attention bias modification (ABM) training to reduce social anxiety in a community-based sample of adolescents 15-18 years. The study used a single-blind, parallel group, randomized controlled trial design (Clinical Trials ID: NCT02270671). Participants were screened in second-level schools using a social anxiety questionnaire. 130 participants scoring ≥24 on the Social Phobia and Anxiety Inventory for Children (SPAI-C) were randomized to the ABM training (n = 66)/placebo (n = 64) group, 120 of which completed pre-, post-, and 12-week follow-up data collection including threat bias, anxiety, and depression measures. The ABM intervention included 4 weekly training sessions using a dot-probe task designed to reduce attention bias to threatening stimuli. ABM training did not alter the primary outcomes of attention bias to threat or social anxiety symptoms raising questions about the efficacy of ABM as an intervention for adolescents.
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http://dx.doi.org/10.1016/j.brat.2016.06.003DOI Listing
September 2016

Modeling problem behaviors in a nationally representative sample of adolescents.

J Adolesc 2016 07 7;50:6-15. Epub 2016 May 7.

School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland; Headstrong: The National Centre for Youth Mental Health, 16 Westland Square, Pearse Street, Dublin 2, Ireland. Electronic address:

Research on multiple problem behaviors has focused on the concept of Problem Behavior Syndrome (PBS). Problem Behavior Theory (PBT) is a complex and comprehensive social-psychological framework designed to explain the development of a range of problem behaviors. This study examines the structure of PBS and the applicability of PBT in adolescents. Participants were 6062 adolescents; aged 12-19 (51.3% female) who took part in the My World Survey-Second Level (MWS-SL). Regarding PBS, Confirmatory Factor Analysis established that problem behaviors, such as alcohol and drug use loaded significantly onto a single, latent construct for males and females. Using Structural Equation Modeling, the PBT framework was found to be a good fit for males and females. Socio-demographic, perceived environment system and personality accounted for over 40% of the variance in problem behaviors for males and females. Our findings have important implications for understanding how differences in engaging in problem behaviors vary by gender.
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http://dx.doi.org/10.1016/j.adolescence.2016.03.010DOI Listing
July 2016

Validation of the Resilience Scale for Adolescents (READ) in Ireland: a multi-group analysis.

Int J Methods Psychiatr Res 2017 06 29;26(2). Epub 2016 Apr 29.

School of Psychology, University College Dublin, Dublin, Ireland.

Resilience is a process reflecting positive adaptation in the face of adversity. The Resilience Scale for Adolescence (READ) incorporates intrapersonal and interpersonal protective factors mapping onto the three salient domains of resilience, including individual, family and external environment. This study investigated the validity and reliability of the READ by means of factor analysis, multi-group analysis, inter-correlations and internal consistency measures. Participants were 6085 young people in Ireland aged 12-18 years. Participants completed the My World Survey - Second Level (MWS-SL), assessing risk and protective factors of mental health. Confirmatory factor analysis validated the original five-factor structure of the READ including Personal Competence, Social Competence, Structured Style, Family Cohesion, and Social Resources, χ (340) = 6146.02, p < 0.001, RMSEA = 0.056 (90% CI = 0.054-0.057), CFI = 0.97; GFI = 0.93. Measurement invariance indicated that the five-factor structure was similar across gender, school cycle and distress levels. Construct validity was evident, by correlating the five factors of the READ with various social, psychological and behavioural variables. The findings suggest that the READ is a valid measure to assess resilience factors among adolescents in Ireland, demonstrating its applicability in a different cultural context and with a wider age range of adolescents. Copyright © 2016 John Wiley & Sons, Ltd.
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http://dx.doi.org/10.1002/mpr.1506DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6877176PMC
June 2017

Feasibility of "CopeSmart": A Telemental Health App for Adolescents.

JMIR Ment Health 2015 Aug 10;2(3):e22. Epub 2015 Aug 10.

School of Psychology, University College Dublin, Dublin 4, Ireland.

Background: Early intervention is important in order to improve mental health outcomes for young people. Given the recent rise in mobile phone ownership among adolescents, an innovative means of delivering such intervention is through the use of mobile phone applications (apps).

Objective: The aim of this study was to evaluate the feasibility of "CopeSmart", a telemental health app developed to foster positive mental health in adolescents through emotional self-monitoring and the promotion of positive coping strategies.

Methods: Forty-three adolescents (88% female) aged 15-17 years downloaded the app and used it over a one-week period. They then completed self-report questionnaires containing both open-ended and closed-ended questions about their experiences of using the app. The app itself captured data related to user engagement.

Results: On average participants engaged with the app on 4 of the 7 days within the intervention period. Feedback from users was reasonably positive, with 70% of participants reporting that they would use the app again and 70% reporting that they would recommend it to a friend. Thematic analysis of qualitative data identified themes pertaining to users' experiences of the app, which were both positive (eg, easy to use, attractive layout, emotional self-monitoring, helpful information, notifications, unique) and negative (eg, content issues, did not make user feel better, mood rating issues, password entry, interface issues, engagement issues, technical fixes).

Conclusions: Overall findings suggest that telemental health apps have potential as a feasible medium for promoting positive mental health, with the majority of young people identifying such technologies as at least somewhat useful and displaying a moderate level of engagement with them. Future research should aim to evaluate the efficacy of such technologies as tools for improving mental health outcomes in young people.
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http://dx.doi.org/10.2196/mental.4370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705022PMC
August 2015

Bisphenol A and Related Alkylphenols Exert Nongenomic Estrogenic Actions Through a G Protein-Coupled Estrogen Receptor 1 (Gper)/Epidermal Growth Factor Receptor (Egfr) Pathway to Inhibit Meiotic Maturation of Zebrafish Oocytes.

Biol Reprod 2015 Dec 21;93(6):135. Epub 2015 Oct 21.

University of Texas at Austin Marine Science Institute, Port Aransas, Texas

Xenobiotic estrogens, such as bisphenol A (BPA), disrupt a wide variety of genomic estrogen actions, but their nongenomic estrogen actions remain poorly understood. We investigated nongenomic estrogenic effects of low concentrations of BPA and three related alkylphenols on the inhibition of zebrafish oocye maturation (OM) mediated through a G protein-coupled estrogen receptor 1 (Gper)-dependent epidermal growth factor receptor (Egfr) pathway. BPA (10-100 nM) treatment for 3 h mimicked the effects of estradiol-17beta (E2) and EGF, decreasing spontaneous maturation of defolliculated zebrafish oocytes, an effect not blocked by coincubation with actinomycin D, but blocked by coincubation with a Gper antibody. BPA displayed relatively high binding affinity (15.8% that of E2) for recombinant zebrafish Gper. The inhibitory effects of BPA were attenuated by inhibition of upstream regulators of Egfr, intracellular tyrosine kinase (Src) with PP2, and matrix metalloproteinase with ilomastat. Treatment with an inhibitor of Egfr transactivation, AG1478, and an inhibitor of the mitogen-activated protein kinase (MAPK) 3/1 pathway, U0126, increased spontaneous OM and blocked the inhibitory effects of BPA, E2, and the selective GPER agonist, G-1. Western blot analysis showed that BPA (10-200 nM) mimicked the stimulatory effects of E2 and EGF on Mapk3/1 phosphorylation. Tetrabromobisphenol A, 4-nonylphenol, and tetrachlorobisphenol A (5-100 nM) also inhibited OM, an effect blocked by cotreatment with AG1478, as well as with the GPER antagonist, G-15, and displayed similar binding affinities as BPA to zebrafish Gper. The results suggest that BPA and related alkylphenols disrupt zebrafish OM by a novel nongenomic estrogenic mechanism involving activation of the Gper/Egfr/Mapk3/1 pathway.
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http://dx.doi.org/10.1095/biolreprod.115.132316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712694PMC
December 2015

Prevalence and correlates of psychotic like experiences in a nationally representative community sample of adolescents in Ireland.

Schizophr Res 2015 Dec 26;169(1-3):241-247. Epub 2015 Sep 26.

School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address:

Adolescent psychotic like experiences (PLEs) are an important area of research, yet only a small number of community surveys have investigated their psychosocial correlates. This study presents the prevalence and correlates of three types of PLEs in a nationally representative community sample of 12-19 year olds in Ireland (N=5910). Correlates are considered across five domains: demographic, stressful life experiences, emotional/behavioral problems, substance use, and personal resources. Auditory hallucinations were reported by 13.7% of participants, 10.4% reported visual hallucinations and 13.1% reported paranoid thoughts. Participants who had experienced two of the three PLEs were assigned "risk" status (10.4%; n=616). Using binary logistic regression, PLEs were associated with a range of correlates across the five domains. Key correlates of risk status include depression (OR 4.07; 95% CI 3.39-4.88), low self-esteem (OR 4.03 95% CI 3.34-4.86), low optimism (OR 3.56; 95% CI 2.96-4.28), school misconduct (OR 3.10 95%; CI 2.56-3.75), and high avoidance coping (OR 2.86 95% CI 2.34-3.49). These associations remained significant in a multivariate analysis. While correlates for each of the three PLEs were similar, there were some nuances in these patterns. Notably, demographic and substance use variables were the weakest groups of correlates. Personal resources (e.g. self-esteem, optimism and coping) have been poorly studied in the adolescent PLE literature and these findings provide important insights for future research and intervention design.
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http://dx.doi.org/10.1016/j.schres.2015.09.005DOI Listing
December 2015

Weight concerns among adolescent boys.

Public Health Nutr 2016 Feb 19;19(3):456-62. Epub 2015 Jun 19.

1Health Promotion Research Centre,School of Health Sciences,National University of Ireland,Galway,Republic of Ireland.

Objective: To investigate weight concerns among adolescent boys and relationships with health indicators and family factors.

Design: Analysis of the 2010 Health Behaviour in School-aged Children survey of 10-17-year-olds.

Setting: Schools in the Republic of Ireland.

Results: Among 6187 boys, 25.1% reported a desire to lose weight (weight 'loss' concern) and 7.7% reported a desire to gain weight (weight 'gain' concern). Both types of weight concerns were associated with poor self-rated health, life satisfaction and happiness, and with more frequent emotional and physical symptoms. Family factors were associated with boys' weight concerns. In adjusted analyses, the risk of weight 'loss' concerns decreased with daily family breakfasts (OR=0.80; 95% CI 0.66, 0.97). The risk of weight 'gain' concerns decreased with frequent family evening meals (OR=0.77; 95% CI 0.60, 0.99). Ease of communication with mother was associated with a decreased risk of weight 'loss' and weight 'gain' concerns among boys (OR=0.74; 95% CI 0.60, 0.90 and OR=0.61; 95% CI 0.44, 0.82, respectively). An open father-son relationship and having a father present in the home decreased the risk of weight 'loss' concerns (OR=0.69; 95% CI 0.57, 0.82 and OR=0.81; 95% CI 0.67, 0.98, respectively).

Conclusions: Body weight concerns were reported by a sizeable minority of boys and were associated with negative health outcomes. The findings support the need to promote frequent family meals and facilitate open communication in families.
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http://dx.doi.org/10.1017/S1368980015001615DOI Listing
February 2016

Developing mental health mobile apps: Exploring adolescents' perspectives.

Health Informatics J 2016 06 10;22(2):265-75. Epub 2014 Nov 10.

University College Dublin, Ireland.

Mobile applications or 'apps' have significant potential for use in mental health interventions with adolescents. However, there is a lack of research exploring end users' needs from such technologies. The aim of this study was to explore adolescents' needs and concerns in relation to mental health mobile apps. Five focus groups were conducted with young people aged 15-16 years (N = 34, 60% male). Participants were asked about their views in relation to the use of mental health mobile technologies and were asked to give their responses to a mental health app prototype. Participants identified (1) safety, (2) engagement, (3) functionality, (4) social interaction, (5) awareness, (6) accessibility, (7) gender and (8) young people in control as important factors. Understanding end users' needs and concerns in relation to this topic will inform the future development of youth-oriented mental health apps that are acceptable to young people.
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http://dx.doi.org/10.1177/1460458214555041DOI Listing
June 2016

Developing mental health mobile apps: Exploring adolescents' perspectives.

Health Informatics J 2016 06 10;22(2):265-75. Epub 2014 Nov 10.

University College Dublin, Ireland.

Mobile applications or 'apps' have significant potential for use in mental health interventions with adolescents. However, there is a lack of research exploring end users' needs from such technologies. The aim of this study was to explore adolescents' needs and concerns in relation to mental health mobile apps. Five focus groups were conducted with young people aged 15-16 years (N = 34, 60% male). Participants were asked about their views in relation to the use of mental health mobile technologies and were asked to give their responses to a mental health app prototype. Participants identified (1) safety, (2) engagement, (3) functionality, (4) social interaction, (5) awareness, (6) accessibility, (7) gender and (8) young people in control as important factors. Understanding end users' needs and concerns in relation to this topic will inform the future development of youth-oriented mental health apps that are acceptable to young people.
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http://dx.doi.org/10.1177/1460458214555041DOI Listing
June 2016

The behavioral pharmacology of zolpidem: evidence for the functional significance of α1-containing GABA(A) receptors.

Psychopharmacology (Berl) 2014 May 22;231(9):1865-96. Epub 2014 Feb 22.

The Department of Anatomy and Neurobiology, Neuroscience Institute, University of Tennessee Health Science Center, 855 Monroe Ave, Memphis, TN, 38163, USA.

Rationale: Zolpidem is a positive allosteric modulator of γ-aminobutyric acid (GABA) with preferential binding affinity and efficacy for α1-subunit containing GABA(A) receptors (α1-GABA(A)Rs). Over the last three decades, a variety of animal models and experimental procedures have been used in an attempt to relate the behavioral profile of zolpidem and classic benzodiazepines (BZs) to their interaction with α1-GABA(A)Rs.

Objectives: This paper reviews the results of rodent and non-human primate studies that have evaluated the effects of zolpidem on motor behaviors, anxiety, memory, food and fluid intake, and electroencephalogram (EEG) sleep patterns. Also included are studies that examined zolpidem's discriminative, reinforcing, and anticonvulsant effects as well as behavioral signs of tolerance and withdrawal.

Results: The literature reviewed indicates that α1-GABA(A)Rs play a principle role in mediating the hypothermic, ataxic-like, locomotor- and memory-impairing effects of zolpidem and BZs. Evidence also suggests that α1-GABA(A)Rs play partial roles in the hypnotic, EEG sleep, anticonvulsant effects, and anxiolytic-like of zolpidem and diazepam. These studies also indicate that α1-GABA(A)Rs play a more prominent role in mediating the discriminative stimulus, reinforcing, hyperphagic, and withdrawal effects of zolpidem and BZs in primates than in rodents.

Conclusions: The psychopharmacological data from both rodents and non-human primates suggest that zolpidem has a unique pharmacological profile when compared with classic BZs. The literature reviewed here provides an important framework for studying the role of different GABA(A)R subtypes in the behavioral effects of BZ-type drugs and helps guide the development of new pharmaceutical agents for disorders currently treated with BZ-type drugs.
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http://dx.doi.org/10.1007/s00213-014-3457-xDOI Listing
May 2014

Causal information on children's attitudes and behavioural intentions toward a peer with obesity.

Obes Facts 2013 28;6(3):247-57. Epub 2013 May 28.

School of Psychology, University College Dublin Belfield, Dublin, Ireland.

Background: This study examined the effect of types of causal information about overweight on children's attitudes and intentions toward a peer presented as overweight.

Methods: Participants (N = 176) were randomly assigned to read a vignette of an overweight peer in one of three conditions, which varied in the explanatory information provided for the aetiology of the peer's overweight condition: biological, environmental or no causal information, along with a vignette of an average-weight peer.

Results: The provision of information that the overweight was the result of biological factors and of no causal information yielded more positive attitudes toward the overweight peer compared to those who were provided with environmental information. Information on overweight had no impact on behavioural intentions. A social desirability bias was found for each of the three experimental conditions and for the average weight condition.

Conclusion: Information explaining overweight had a minimal positive effect on attitudes and no effect on intentions toward an overweight peer.
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http://dx.doi.org/10.1159/000351828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644733PMC
December 2013

Interpersonal relationships and emotional distress in adolescence.

J Adolesc 2013 Apr 13;36(2):351-60. Epub 2013 Feb 13.

School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.

The aim of this study was to examine positive and negative qualities in adolescents' interpersonal relationships and their relative importance in predicting emotional distress. Participants were 260 students from three schools in the Dublin area (119 girls; 141 boys), aged 12-18 years (M = 15.32, SD = 1.91). Students completed questionnaires assessing qualities in important interpersonal relationships in their lives and emotional distress. Girls reported more positive qualities in their relationships with mothers and best friends than boys. Younger students reported more positive qualities in their relationships with parents than older students. Stepwise multiple regression analysis revealed high levels of satisfaction in interpersonal relationships were predictive of low levels of emotional distress whereas high levels of criticism and exclusion were predictive of high levels of distress. High levels of support and disclosure were also linked to emotional distress. These findings and their implications are discussed in detail.
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http://dx.doi.org/10.1016/j.adolescence.2012.12.005DOI Listing
April 2013

Self-efficacy for healthy eating and peer support for unhealthy eating are associated with adolescents' food intake patterns.

Appetite 2013 Apr 23;63:48-58. Epub 2012 Dec 23.

School of Psychology, University College Dublin, Dublin, Ireland.

Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset of obesity. It is considered that peers have an important role to play on adolescents' diet, however, limited research has examined the role of peers in this context. This study examined the relationship between self-efficacy for healthy eating, parent and peer support for healthy and unhealthy eating and food intake patterns. Participants were 264 boys and 219 girls (N=483), aged 13-18years, recruited from post-primary schools in Ireland. Self-report measures assessed self-efficacy, parent and peer support for healthy eating, and for unhealthy eating. Dietary pattern analysis, a popular alternative to traditional methods used in nutritional research, was conducted on a FFQ to derive food intake patterns. Two patterns were identified labelled 'healthy food intake' and 'unhealthy food intake'. Multi-group modelling was used to evaluate whether the hypothesized model of factors related to dietary patterns differed by gender. The multi-group model fit the data well, with only one path shown to differ by gender. Lower self-efficacy for healthy eating and higher peer support for unhealthy eating were associated with 'unhealthy food intake'. Higher self-efficacy was associated with 'healthy food intake'. Prevention programs that target self-efficacy for eating and peer support for unhealthy eating may be beneficial in improving dietary choices among adolescents.
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http://dx.doi.org/10.1016/j.appet.2012.12.011DOI Listing
April 2013

Methodology on the My World Survey (MWS): a unique window into the world of adolescents in Ireland.

Early Interv Psychiatry 2013 Feb 4;7(1):12-22. Epub 2012 Sep 4.

School of Psychology, University College Dublin, Dublin, Ireland.

Background: Internationally, 75% of all mental health problems emerge before the age of 25 years, and adolescence represents a critical period that strongly influences the course of these problems. To date, there is limited research on the mental health of young people aged 12-25 years in Ireland. The My World Survey (MWS) national study provides data on risk and protective factors of mental health among 14 306 young people. The MWS was conducted in two phases: Phase 1 - MWS-Second Level (MWS-SL) with adolescents aged 12-19 years, and Phase 2 - MWS-Post Second Level among young adults aged 17-25 years.

Aim: This article provides a comprehensive overview of the development of the MWS-SL study. Another aim is to identify key learning points when conducting research in the second-level school system.

Methods: The MWS-SL study was conducted with 6085 adolescents aged 12-19 years in 72 second-level schools. The MWS consists of standardized reliable and valid measures that have been used internationally to assess a range of risk and protective factors associated with adolescent mental health.

Results: Schools recruited for the MWS-SL study represented quite well the national distribution of second-level schools based on gender composition, disadvantaged/non-disadvantaged status and geographic location.

Conclusions: Key learning points when collecting survey data in schools include pilot testing of survey instruments; building relationships with key stakeholders to ensure buy-in for the study from schools; establishing rigorous data collection and processing protocols; and recognizing the value of online surveys.
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http://dx.doi.org/10.1111/j.1751-7893.2012.00386.xDOI Listing
February 2013
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