Publications by authors named "Daniel B Fassnacht"

20 Publications

  • Page 1 of 1

Testing the Differential Impact of an Internet-Based Mental Health Intervention on Outcomes of Well-being and Psychological Distress During COVID-19: Uncontrolled Intervention Study.

JMIR Ment Health 2021 Sep 15;8(9):e28044. Epub 2021 Sep 15.

Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia.

Background: During COVID-19, the psychological distress and well-being of the general population has been precarious, increasing the need to determine the impact of complementary internet-based psychological interventions on both positive mental health as well as distress states. Psychological distress and mental well-being represent distinct dimensions of our mental health, and congruent changes in outcomes of distress and well-being do not necessarily co-occur within individuals. When testing intervention impact, it is therefore important to assess change in both outcomes at the individual level, rather than solely testing group differences in average scores at the group level.

Objective: This study set out to investigate the differential impact of an internet-based group mental health intervention on outcomes of positive mental health (ie, well-being, life satisfaction, resilience) and indicators of psychological distress (ie, depression, anxiety, stress).

Methods: A 5-week mental health intervention was delivered to 89 participants using the Zoom platform during 2020. Impact on outcomes of distress, well-being, and resilience was assessed at the start and end of the program with multiple analysis of variance (MANOVA) and reliable change indices (RCIs) being used to determine program impact at the group and individual levels, respectively.

Results: The intervention significantly improved all mental health outcomes measured, (F=5.60, P<.001; Wilks Λ=.71; partial η=.29) showing small to moderate effect sizes on individual outcomes. The largest effect sizes were observed for life satisfaction and overall well-being (η=.22 and η=.2, respectively). Larger effect sizes were noted for those with problematic mental health scores at baseline. A total of 92% (82/89) of participants demonstrated reliable change in at least one mental health outcome. Differential response patterns using RCI revealed that more than one-half of the participants showed improvement in both mental well-being and psychological distress, over one-quarter in outcomes of well-being only, and almost one-fifth in distress only.

Conclusions: The results provide evidence for the significant impact of an internet-based mental health intervention during COVID-19 and indicate the importance of assessing dimensions of both well-being and distress when determining mental health intervention effectiveness.
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http://dx.doi.org/10.2196/28044DOI Listing
September 2021

Contemporary treatment of anxiety in primary care: a systematic review and meta-analysis of outcomes in countries with universal healthcare.

BMC Fam Pract 2021 05 15;22(1):92. Epub 2021 May 15.

College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.

Background: Anxiety disorders are highly prevalent mental health conditions and are managed predominantly in primary care. We conducted a systematic review and meta-analysis of psychological and pharmacological treatments in countries with universal healthcare, and investigated the influence of treatment provider on the efficacy of psychological treatment.

Method: PubMed, Cochrane, PsycINFO, CINAHL, and Scopus were searched in April 2017 for controlled studies of evidence-based anxiety treatment in adults in primary care, published in English since 1997. Searches were repeated in April 2020. We synthesised results using a combination of meta-analysis and narrative methods. Meta-analysis was conducted using a random-effects multi-level model to account for intercorrelation between effects contributed different treatment arms of the same study. Moderator variables were explored using meta-regression analyses.

Results: In total, 19 articles (from an initial 2,247) reporting 18 studies were included. Meta-analysis including ten studies (n = 1,308) found a pooled effect size of g = 1.16 (95%CI = 0.63 - 1.69) for psychological treatment compared to waitlist control, and no significant effect compared to care as usual (p = .225). Substantial heterogeneity was present (I = 81.25). Specialist treatment produced large effects compared to both waitlist control (g = 1.46, 95%CI = 0.96 - 1.96) and care as usual (g = 0.76, 95%CI = 0.27 - 1.25). Treatment provided by non-specialists was only superior to waitlist control (g = 0.80, 95%CI = 0.31 - 1.28). We identified relatively few studies (n = 4) of medications, which reported small to moderate effects for SSRI/SNRI medications and hydroxyzine. The quality of included studies was variable and most studies had at least "unclear" risk of bias in one or more key domains.

Conclusions: Psychological treatments for anxiety are effective in primary care and are more effective when provided by a specialist (psychologist or clinical psychologist) than a non-specialist (GP, nurse, trainee). However, non-specialists provide effective treatment compared with no care at all. Limited research into the efficacy of pharmacological treatments in primary care needs to be considered carefully by prescribers TRIAL REGISTRATION: PROSPERO registration number CRD42018050659.
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http://dx.doi.org/10.1186/s12875-021-01445-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126070PMC
May 2021

Proposed diagnostic criteria for compulsive buying-shopping disorder: A Delphi expert consensus study.

J Behav Addict 2021 Apr 13. Epub 2021 Apr 13.

4College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.

Background And Aims: Consensus in acknowledging compulsive buying-shopping disorder (CBSD) as a distinct diagnosis has been lacking. Before research in this area can be advanced, it is necessary to establish diagnostic criteria in order to facilitate field trials.

Methods: The study consisted of the following phases: (1) operationalization of a broad range of potential diagnostic criteria for CBSD, (2) two iterative rounds of data collection using the Delphi method, where consensus of potential diagnostic criteria for CBSD was reached by an international expert panel, and (3) interpretation of findings taking into account the degree of certainty amongst experts regarding their responses.

Results: With respect to diagnostic criteria, there was clear expert consensus about inclusion of the persistent and recurrent experience of (a) intrusive and/or irresistible urges and/or impulses and/or cravings and/or preoccupations for buying/shopping; (b) diminished control over buying/shopping; (c) excessive purchasing of items without utilizing them for their intended purposes, (d) use of buying-shopping to regulate internal states; (e) negative consequences and impairment in important areas of functioning due to buying/shopping; (f) emotional and cognitive symptoms upon cessation of excessive buying/shopping; and (g) maintenance or escalation of dysfunctional buying/shopping behaviors despite negative consequences. Furthermore, support was found for a specifier related to the presence of excessive hoarding of purchased items.

Conclusions: The proposed diagnostic criteria can be used as the basis for the development of diagnostic interviews and measures of CBSD severity.
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http://dx.doi.org/10.1556/2006.2021.00013DOI Listing
April 2021

Using Internet-Based Psychological Measurement to Capture the Deteriorating Community Mental Health Profile During COVID-19: Observational Study.

JMIR Ment Health 2020 Jun 11;7(6):e20696. Epub 2020 Jun 11.

College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.

Background: The coronavirus disease (COVID-19) is expected to have widespread and pervasive implications for mental health in terms of deteriorating outcomes and increased health service use, leading to calls for empirical research on mental health during the pandemic. Internet-based psychological measurement can play an important role in collecting imperative data, assisting to guide evidence-based decision making in practice and policy, and subsequently facilitating immediate reporting of measurement results to participants.

Objective: The aim of this study is to use an internet-based mental health measurement platform to compare the mental health profile of community members during COVID-19 with community members assessed before the pandemic.

Methods: This study uses an internet-based self-assessment tool to collect data on psychological distress, mental well-being, and resilience in community cohorts during (n=673) and prior to the pandemic (two cohorts, n=1264 and n=340).

Results: Our findings demonstrate significantly worse outcomes on all mental health measures for participants measured during COVID-19 compared to those measured before (P<.001 for all outcomes, effect sizes ranging between Cohen d=0.32 to Cohen d=0.81. Participants who demonstrated problematic scores for at least one of the mental health outcomes increased from 58% (n=197/340) before COVID-19 to 79% (n=532/673) during COVID-19, leading to only 21% (n=141) of measured participants displaying good mental health during the pandemic.

Conclusions: The results clearly demonstrate deterioration in mental health outcomes during COVID-19. Although further research is needed, our findings support the serious mental health implications of the pandemic and highlight the utility of internet-based data collection tools in providing evidence to innovate and strengthen practice and policy during and after the pandemic.
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http://dx.doi.org/10.2196/20696DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294997PMC
June 2020

Are Fitbits implicated in body image concerns and disordered eating in women?

Health Psychol 2020 Oct 14;39(10):900-904. Epub 2020 May 14.

School of Psychological Sciences.

Objective: Using a daily monitoring framework, we examined the psychological consequences of Fitbit self-tracking on state body satisfaction, disordered eating (DE; i.e., binge eating and dietary restraint), levels of exercise engagement, and motivations (appearance vs. fitness/health) in adult women. A further aim within the Fitbit group was to assess whether the level of steps achieved on 1 day would be associated with the state-based outcome measures on the subsequent day.

Method: In total, 262 participants who had never used a wearable fitness self-tracking device were allocated to a Fitbit ( = 101) or control condition ( = 161). Participants provided baseline data on sociodemographics, eating pathology, and exercise and then completed a 10-day Ecological Momentary Assessment (EMA) protocol assessing exercise amount and motives, body satisfaction, and DE symptoms via a mobile application. Those in the Fitbit condition wore a Fitbit over the entire assessment period.

Results: The use of a Fitbit over a 10-day period had no significant effects on exercise behavior or body satisfaction compared to a control group. However, those in the Fitbit group were more likely to exercise to reach fitness goals and less likely to engage in dietary restraint and binge-eating behavior. Among participants in the Fitbit condition, steps achieved the previous day were not predictive of exercise engagement, body satisfaction, or DE symptoms on the subsequent day.

Conclusions: Our study failed to link fitness self-tracking to body dissatisfaction and DE, at least in the early stages of use. Future research directions regarding alternative pathways through which self-tracking devices may exert negative influences are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/hea0000881DOI Listing
October 2020

What prevents young adults from seeking help? Barriers toward help-seeking for eating disorder symptomatology.

Int J Eat Disord 2020 06 2;53(6):894-906. Epub 2020 Apr 2.

Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany.

Objectives: The aim of this study was to investigate help-seeking attitudes, intentions, and behaviors, and to systematically explore perceived barriers to help-seeking for eating, weight, or shape concerns among young adults. Differences in perceived barriers as a function of type of eating disorder symptomatology were also examined.

Method: Data were collected using an online survey among individuals (aged 18-25 years) in Australia. Overall, 291 young adults with varying levels of eating disorder symptoms completed measures of disordered eating, weight or shape concerns, help-seeking barriers, attitudes, intentions, and behaviors. According to their self-reported symptoms, participants were classified into four subgroups (i.e., anorexia nervosa [AN] symptoms, bulimia nervosa [BN] symptoms, binge-eating disorder [BED] symptoms, and other eating disorder symptoms).

Results: Despite the belief that help-seeking is useful, only a minority of participants with elevated symptoms, namely those with AN, BN, and BED symptoms, believed they needed help. Across the sample, the most frequently cited barriers to seeking help for eating disorder symptoms were: concern for others, self-sufficiency, fear of losing control, denial and failure to perceive the severity of the illness, and stigma and shame.

Discussion: The findings highlight the need to educate young adults about the severity of eating disorders and the importance of seeking help, and to increase the awareness of help-seeking barriers among those designing public health interventions as well as clinicians. Our findings suggest that help-seeking barriers may differ depending on the type of eating disorder symptomology.
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http://dx.doi.org/10.1002/eat.23266DOI Listing
June 2020

A novel multi-component online intervention to improve the mental health of university students: Randomised controlled trial of the Uni Virtual Clinic.

Internet Interv 2019 Dec 28;18:100276. Epub 2019 Aug 28.

Centre for Mental Health Research, The Australian National University, Australia.

Background: Of the millions of students enrolled in university, up to 50% will experience a mental disorder. Many of these students do not seek help, and for those who do, university-based services are often over-burdened. Anonymous, evidence-based, online interventions can improve students' access to mental health support. The Uni Virtual Clinic (UVC) is a transdiagnostic online mental health program designed specifically for university students. This paper reports on a randomised controlled trial examining the effectiveness of the UVC in a sample of Australian university students.

Methods: University students with elevated psychological distress (K10>15;  = 200) were randomised to the UVC intervention or a waitlist control condition for a period of 6 weeks. Baseline, post-intervention, and 3-month follow-up surveys assessed depression, anxiety, self-efficacy, quality of life, adherence, and satisfaction with the UVC intervention.

Results: Mixed models analysis demonstrated that use of the UVC was associated with small significant reductions in social anxiety and small improvements in academic self-efficacy. The program was not effective in reducing symptoms of depression, anxiety, or psychological distress compared to a control group. The majority of participants in the intervention condition who were retained at follow-up engaged with the program, and most of these participants reported satisfaction with the UVC.

Discussion: The results suggest that multi-component online interventions such as the UVC have utility in a university environment. Future trials of the UVC should examine the impact of guidance and/or tailoring on treatment efficacy, and the potential role of the UVC in a stepped care model incorporating on-campus services.
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http://dx.doi.org/10.1016/j.invent.2019.100276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926241PMC
December 2019

A novel multi-component online intervention to improve the mental health of university students: Randomised controlled trial of the Uni Virtual Clinic.

Internet Interv 2019 Dec 28;18:100276. Epub 2019 Aug 28.

Centre for Mental Health Research, The Australian National University, Australia.

Background: Of the millions of students enrolled in university, up to 50% will experience a mental disorder. Many of these students do not seek help, and for those who do, university-based services are often over-burdened. Anonymous, evidence-based, online interventions can improve students' access to mental health support. The Uni Virtual Clinic (UVC) is a transdiagnostic online mental health program designed specifically for university students. This paper reports on a randomised controlled trial examining the effectiveness of the UVC in a sample of Australian university students.

Methods: University students with elevated psychological distress (K10>15;  = 200) were randomised to the UVC intervention or a waitlist control condition for a period of 6 weeks. Baseline, post-intervention, and 3-month follow-up surveys assessed depression, anxiety, self-efficacy, quality of life, adherence, and satisfaction with the UVC intervention.

Results: Mixed models analysis demonstrated that use of the UVC was associated with small significant reductions in social anxiety and small improvements in academic self-efficacy. The program was not effective in reducing symptoms of depression, anxiety, or psychological distress compared to a control group. The majority of participants in the intervention condition who were retained at follow-up engaged with the program, and most of these participants reported satisfaction with the UVC.

Discussion: The results suggest that multi-component online interventions such as the UVC have utility in a university environment. Future trials of the UVC should examine the impact of guidance and/or tailoring on treatment efficacy, and the potential role of the UVC in a stepped care model incorporating on-campus services.
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http://dx.doi.org/10.1016/j.invent.2019.100276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926241PMC
December 2019

Therapist-Assisted Internet-Based Cognitive Behavioral Therapy Versus Progressive Relaxation in Obsessive-Compulsive Disorder: Randomized Controlled Trial.

J Med Internet Res 2018 08 8;20(8):e242. Epub 2018 Aug 8.

Department of Statistics Data Science and Epidemiology, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.

Background: Obsessive-compulsive disorder (OCD) is a highly disabling psychological disorder with a chronic course if left untreated. Cognitive behavioral therapy (CBT) has been shown to be an effective treatment, but access to face-to-face CBT is not always possible. Internet-based CBT (iCBT) has become an increasingly viable option. However, no study has compared iCBT to an analogous control condition using a randomized controlled trial (RCT).

Objective: A 2-armed RCT was used to compare a therapist-assisted 12-module iCBT to an analogous active attention control condition (therapist-assisted internet-based standard progressive relaxation training, iPRT) in adult OCD. This paper reports pre-post findings for OCD symptom severity.

Method: In total, 179 participants (117 females, 65.7%) were randomized (stratified by gender) into iCBT or iPRT. The iCBT intervention included psychoeducation, mood and behavioral management, exposure and response prevention (ERP), cognitive therapy, and relapse prevention; the iPRT intervention included psychoeducation and relaxation techniques as a way of managing OCD-related anxiety but did not incorporate ERP or other CBT elements. Both treatments included audiovisual content, case stories, demonstrations of techniques, downloadable audio content and worksheets, and expert commentary. All participants received 1 weekly email, with a maximum 15-minute preparation time per client from a remote therapist trained in e-therapy. Emails aimed to monitor progress, provide support and encouragement, and assist in individualizing the treatment. Participants were assessed for baseline and posttreatment OCD severity with the telephone-administered clinician-rated Yale-Brown Obsessive-Compulsive Scale and other measures by assessors who were blinded to treatment allocation.

Results: No pretreatment differences were found between the 2 conditions. Intention-to-treat analysis revealed significant pre-post improvements in OCD symptom severity for both conditions (P<.001). However, relative to iPRT, iCBT showed significantly greater symptom severity improvement (P=.001); Cohen d for iCBT was 1.05 (95% CI 0.72-1.37), whereas for iPRT it was 0.48 (95% CI 0.22-0.73). The iCBT condition was superior in regard to reliable improvement (25/51, 49% vs 16/55, 29%; P=.04) and clinically significant pre-post-treatment changes (17/51, 33% vs 6/55, 11%; P=.005). Those undertaking iCBT post completion of iPRT showed further significant symptom amelioration (P<.001), although the sequential treatment was no more efficacious than iCBT alone (P=.63).

Conclusion: This study is the first to compare a therapist-assisted iCBT program for OCD to an analogous active attention control condition using iPRT. Our findings demonstrate the large magnitude effect of iCBT for OCD; interestingly, iPRT was also moderately efficacious, albeit significantly less so than the iCBT intervention. The findings are compared to previous internet-based and face-to-face CBT treatment programs for OCD. Future directions for technology-enhanced programs for the treatment of OCD are outlined.

Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12611000321943; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336704 (Archived by WebCite at http://www.webcitation.org/70ovUiOmd).
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http://dx.doi.org/10.2196/jmir.9566DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105869PMC
August 2018

The cognitive-behavioural model of hoarding disorder: Evidence from clinical and non-clinical cohorts.

Clin Psychol Psychother 2018 Mar 20;25(2):311-321. Epub 2017 Dec 20.

Research School of Psychology, The Australian National University, Canberra, Australia.

The cognitive-behavioural model of hoarding disorder incorporates information processing difficulties, maladaptive attachment to possessions, erroneous beliefs about the nature of possessions, and mood problems as etiologically significant factors, although developmental experiences such as a compromised early family environment have also been proposed in an augmented model. This study examined the specificity and relevance of variables highlighted in the augmented cognitive-behavioural model. Various clinical participants (n = 89) and community controls (n = 20) were assessed with structured clinical interviews to verify diagnosis. Participants completed self-report measures of hoarding severity, cognitions, meta-memory, and early developmental experiences (e.g., memories of warmth and security in one's family). Hoarding cohorts (with and without obsessive-compulsive disorder) reported poor confidence in memory, but relative to other groups (obsessive-compulsive disorder without hoarding disorder, anxiety disorders, and healthy controls), hoarding-relevant cognitions, need to keep possessions in view, and concerns about the consequences of forgetting were significantly higher. Hoarding groups reported the lowest recollections of warmth in their family, although no differences were found between hoarding and non hoarding clinical cohorts for uncertainty about self and others. Nonetheless, clinical cohorts reported generally higher scores of uncertainty than healthy controls. When predicting hoarding severity, after controlling for age and mood, recollections of lack of warmth in one's family was a significant predictor of hoarding severity, with hoarding-related cognitions and fears about decision-making being additional unique predictors. The study supports the augmented cognitive-behavioural model of hoarding, inclusive of the importance of early developmental influences in hoarding.
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http://dx.doi.org/10.1002/cpp.2164DOI Listing
March 2018

Perceived barriers and facilitators towards help-seeking for eating disorders: A systematic review.

Int J Eat Disord 2017 Jan 16;50(1):9-21. Epub 2016 Aug 16.

Centre for Mental Health Research, the Australian National University, Canberra, Australia.

Objective: To systematically review the literature on perceived barriers and facilitators of help-seeking for eating disorders.

Method: Three databases (PubMed, PsychInfo, Cochrane) were searched using keywords and Medical Subject Headings (MeSH) terms. Retrieved abstracts (N = 3493) were double screened and relevant papers (n = 13) were double coded. Qualitative and quantitative studies were included if they reported perceived barriers and facilitators towards seeking help for eating disorders. Barriers and facilitators were extracted from the included papers and coded under themes. The most prominent barriers and facilitators were determined by the number of studies reporting each theme.

Results: Eight qualitative, three quantitative, and two mixed-methods studies met the inclusion criteria for the current review. The most prominent perceived barriers to help-seeking were stigma and shame, denial of and failure to perceive the severity of the illness, practical barriers (e.g., cost of treatment), low motivation to change, negative attitudes towards seeking help, lack of encouragement from others to seek help and lack of knowledge about help resources. Facilitators of help-seeking were reported in six studies, with the most prominent themes identified as the presence of other mental health problems or emotional distress, and concerns about health.

Discussion: Programs targeting prevention and early intervention for eating disorders should focus on reducing stigma and shame, educating individuals about the severity of eating disorders, and increasing knowledge around help-seeking pathways for eating disorders. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:9-21).
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http://dx.doi.org/10.1002/eat.22598DOI Listing
January 2017

Demographic and psychosocial predictors of major depression and generalised anxiety disorder in Australian university students.

BMC Psychiatry 2016 07 15;16:241. Epub 2016 Jul 15.

National Institute for Mental Health Research, The Australian National University, Building 63, Eggleston Road, Canberra, ACT, 2061, Australia.

Background: Few studies have examined modifiable psychosocial risk factors for mental disorders among university students, and of these, none have employed measures that correspond to clinical diagnostic criteria. The aim of this study was to examine psychosocial and demographic risk factors for major depression and generalised anxiety disorder (GAD) in a sample of Australian university students.

Methods: An anonymous web-based survey was distributed to undergraduate and postgraduate students at a mid-sized Australian university. A range of psychosocial and demographic risk factors were measured, and logistic regression models were used to examine significant predictors of major depression and GAD.

Results: A total of 611 students completed the survey. The prevalence of major depression and GAD in the sample was 7.9 and 17.5 %, respectively. In terms of demographic factors, the risk of depression was higher for students in their first year of undergraduate study, and the risk of GAD was higher for female students, those who moved to attend university, and students experiencing financial stress. In terms of psychosocial factors, students with experience of body image issues and lack of confidence were at significantly greater risk of major depression, and feeling too much pressure to succeed, lack of confidence, and difficulty coping with study was significantly associated with risk of GAD.

Conclusions: University students experience a range of unique psychosocial stressors that increase their risk of major depression and GAD, in addition to sociodemographic risk factors. It is important to examine psychosocial factors, as these are potentially modifiable and could be the focus of university-specific mental health interventions.
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http://dx.doi.org/10.1186/s12888-016-0961-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946110PMC
July 2016

Implicit and explicit anti-fat bias among Asian females.

Eat Weight Disord 2017 Sep 20;22(3):457-465. Epub 2016 May 20.

Department of Psychology, James Cook University, Singapore, Singapore.

Obesity is not only associated with an increased risk of numerous health problems, but also with high rates of stigmatization and weight-related bias. Anti-fat attitudes have been shown to be prevalent in Western samples; however, there is a lack of studies investigating both implicit and explicit anti-fat bias in Asian populations. There is also limited research investigating the relationship between anti-fat attitudes and weight-related behavioral intentions. Thus, this study aimed to examine anti-fat bias and its effect on behavioral intentions using three types of measures-implicit, explicit, and a revised behavioral intention measure-in a sample of 104 Asian females in Singapore. Significant differences were found between implicit and explicit bias: on average, participants exhibited strong implicit but no explicit anti-fat bias (p < 0.001). Furthermore, only implicit anti-fat bias was found to be a significant predictor of behavioral intentions (p < 0.05), after accounting for body mass index, and sociodemographic variables. In conclusion, the present study revealed that implicit anti-fat bias is present among Asian females and is a valid predictor of weight-related behavioral intentions. However, anti-fat bias is often not expressed explicitly, possibly influenced by collectivistic beliefs. More studies are needed to better understand similarities and differences between Asian and Western populations regarding attitudes toward overweight and obese individuals.
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http://dx.doi.org/10.1007/s40519-016-0290-8DOI Listing
September 2017

Recruiting for health, medical or psychosocial research using Facebook: Systematic review.

Internet Interv 2016 May 27;4:72-81. Epub 2016 Apr 27.

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

Recruiting participants is a challenge for many health, medical and psychosocial research projects. One tool more frequently being used to improve recruitment is the social networking website Facebook. A systematic review was conducted to identify studies that have used Facebook to recruit participants of all ages, to any psychosocial, health or medical research. 110 unique studies that used Facebook as a recruitment source were included in the review. The majority of studies used a cross-sectional design (80%) and addressed a physical health or disease issue (57%). Half (49%) of the included studies reported specific details of the Facebook recruitment process. Researchers paid between $1.36 and $110 per completing participants (Mean = $17.48, SD = $23.06). Among studies that examined the representativeness of their sample, the majority concluded (86%) their Facebook-recruited samples were similarly representative of samples recruited via traditional methods. These results indicate that Facebook is an effective and cost-efficient recruitment method. Researchers should consider their target group, advertisement wording, offering incentives and no-cost methods of recruitment when considering Facebook as a recruitment source. It is hoped this review will assist researchers to make decisions regarding the use of Facebook as a recruitment tool in future research.
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http://dx.doi.org/10.1016/j.invent.2016.02.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096238PMC
May 2016

Parental comments: Relationship with gender, body dissatisfaction, and disordered eating in Asian young adults.

Body Image 2016 Mar 12;16:93-9. Epub 2016 Jan 12.

James Cook University, Singapore, Singapore; Research School of Psychology, The Australian National University, Canberra, ACT, Australia.

The present study explored the relationships between different categories of parental comments (negative, positive, and importance and comparison), body dissatisfaction, and disordered eating concerns in 383 young adults (69% female) in Singapore. Self-report measures of parental comments, body dissatisfaction, and disordered eating were completed with results indicating that females, compared to males, reported significantly higher levels of body dissatisfaction, disordered eating, and negative maternal and positive paternal comments. Although the relationships found between the different categories of parental comments, body dissatisfaction, and disordered eating differed by gender, negative maternal comments emerged as a consistent predictor of disordered eating for both genders. This relationship was partially mediated by body dissatisfaction. The findings highlight the role of parental influence through weight-related comments on body dissatisfaction and disordered eating, and the need for further exploration of gender-specific pathways of parental influence.
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http://dx.doi.org/10.1016/j.bodyim.2015.12.001DOI Listing
March 2016

Predictors of response to cognitive behaviour therapy for obsessive-compulsive disorder.

Int J Clin Health Psychol 2015 Sep-Dec;15(3):181-190. Epub 2015 Aug 10.

The Australian National University, Australia.

Response to psychological treatment for Obsessive-Compulsive Disorder (OCD) varies, and dropout and relapse rates remain troubling. However, while studies examining symptom reductions are favourable, outcomes are less encouraging when outcome is defined in terms of clinically significant change. Moreover, there is little understanding of what predicts treatment outcome. This study examined demographic, symptomatic and cognitive predictors of outcome in 79 participants undertaking individualised cognitive-behavioural therapy for OCD. After investigating differences between treatment completers and non-completers, we examined treatment response as defined by post-treatment symptom severity and clinically reliable change, as well as predictors of treatment response. Completers were less likely to present with co-morbidity. The treatment was highly efficacious irrespective of whether completer or intention-to-treat analysis was undertaken, with 58% of treatment completers considered "recovered" at post-treatment. Lower pre-treatment levels of OCD symptoms and greater perfectionism/intolerance of uncertainty were the best unique predictors of OCD severity outcomes at post-treatment. Changes in obsessional beliefs were associated with symptomatic change, although only perfectionism/intolerance of uncertainty was a significant unique predictor of post-treatment change. Recovery status was predicted only by pre-treatment OCD severity. In helping to identify those at risk for poorer outcomes, such research can lead to the development of more effective interventions.
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http://dx.doi.org/10.1016/j.ijchp.2015.07.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225019PMC
August 2015

Promoting health behaviour in Portuguese children via Short Message Service: The efficacy of a text-messaging programme.

J Health Psychol 2015 Jun;20(6):806-15

Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal

A Short Message Service programme was adapted to monitor three health behaviours and provide supportive feedback. The study aimed to evaluate the effectiveness of the programme to increase fruit/vegetable consumption and physical activity and to decrease screen time. A total of 139 Portuguese children, aged 8-10 years, grouped by classroom, were randomly assigned to an intervention (8 weeks of monitoring/feedback) or a control condition. Participants had their key behaviours assessed at baseline, post-intervention and follow-up. A three-level hierarchical linear model was developed. Results showed that the monitoring and feedback programme significantly increased fruit and vegetable consumption over time.
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http://dx.doi.org/10.1177/1359105315577301DOI Listing
June 2015

The Portuguese version of the Outcome Questionnaire (OQ-45): Normative data, reliability, and clinical significance cut-offs scores.

Psychol Psychother 2015 Dec 8;88(4):427-37. Epub 2014 Dec 8.

Psychotherapy and Psychopathology Research Unit - CIPsi, School of Psychology, University of Minho, Braga, Portugal.

Objectives: The Outcome Questionnaire (OQ-45) is one of the most extensively used standardized self-report instruments to monitor psychotherapy outcomes. The questionnaire is designed specifically for the assessment of change during psychotherapy treatments. Therefore, it is crucial to provide norms and clinical cut-off values for clinicians and researchers. The current study aims at providing study provides norms, reliability indices, and clinical cut-off values for the Portuguese version of the scale.

Method: Data from two large non-clinical samples (high school/university, N = 1,669; community, N = 879) and one clinical sample (n = 201) were used to investigate psychometric properties and derive normative data for all OQ-45 subscales and the total score.

Results: Significant and substantial differences were found for all subscales between the clinical and non-clinical sample. The Portuguese version also showed adequate reliabilities (internal consistency, test-retest), which were comparable to the original version. To assess individual clinical change, clinical cut-off values and reliable change indices were calculated allowing clinicians and researchers to monitor and evaluate clients' individual change.

Conclusion: The Portuguese version of the OQ-45 is a reliable instrument with comparable Portuguese norms and cut-off scores to those from the original version. This allows clinicians and researchers to use this instrument for evaluating change and outcome in psychotherapy.

Practitioner Points: This study provides norms for non-clinical and clinical Portuguese samples and investigates the reliability (internal consistency and test-retest) of the OQ-45. Cut-off values and reliable change index are provided allowing clinicians to evaluate clinical change and clients' response to treatment, monitoring the quality of mental health care services. These can be used, in routine clinical practice, as benchmarks for treatment progress and to empirically base clinical decisions such as continuation of treatment or considering termination.
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http://dx.doi.org/10.1111/papt.12048DOI Listing
December 2015

Use of text messaging services to promote health behaviors in children.

J Nutr Educ Behav 2015 Jan-Feb;47(1):75-80. Epub 2014 Oct 2.

Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Braga, Portugal. Electronic address:

Objective: To examine adherence to, satisfaction with, and preliminary efficacy of mobile phone short message service (SMS) to promote health behaviors in school-aged children.

Methods: A total of 49 children (aged 8-10 years) were randomized by school classes into a monitoring vs no-monitoring group. All children participated in 2 educational group sessions that focused on health behaviors: the advantages of increasing fruit and vegetable consumption and physical activity, and decreasing screen time. The monitoring group also reported daily behavior using SMS and received supportive feedback for 8 weeks.

Results: Children submitted 61% of the required SMS, which indicated good adherence to the intervention. A number of children (95%) reported being satisfied with the program. Analyses of covariance indicated increase in fruit and vegetable consumption (χ² [2] = 7.27; P < .05) and a decrease in screen time (χ² [2] = 6.79; P < .05).

Conclusions And Implications: The current SMS intervention was a useful tool to monitor and promote health behaviors in children.
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http://dx.doi.org/10.1016/j.jneb.2014.08.006DOI Listing
August 2015

Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy.

J Affect Disord 2014 2;167:64-73. Epub 2014 Jun 2.

Department of Mathematics and Applications, University of Minho, Portugal.

Background: In a previous clinical controlled trial (Lopes et al., 2014), narrative therapy (NT) showed promising results in ameliorating depressive symptoms with comparable outcomes to cognitive-behavioral therapy (CBT) when patients completed treatment. This paper aims to assess depressive symptoms and interpersonal problems in this clinical sample at follow-up.

Methods: Using the Beck Depression Inventory-II and Outcome Questionnaire-45.2 Interpersonal Relations Scale, naturalistic prospective follow-up assessment was conducted at 21 and 31 months after the last treatment session.

Results: At follow-up, patients kept improving in terms of depressive symptoms and interpersonal problems. The odds that a patient maintained recovery from depressive symptoms at follow-up were five times higher than the odds that a patient maintained recovery from interpersonal problems. In the same way, the odds of a patient never recovering from interpersonal problems were five times higher than the odds of never recovering from depressive symptoms.

Limitations: The study did not control for the natural course of depression or treatment continuation.

Conclusions: For depressed patients with greater interpersonal disabilities, longer treatment plans and alternative continuation treatments should be considered.
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http://dx.doi.org/10.1016/j.jad.2014.05.042DOI Listing
May 2015
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