Publications by authors named "Kathina Ali"

10 Publications

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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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September 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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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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June 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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June 2020

University staff experiences of students with mental health problems and their perceptions of staff training needs.

J Ment Health 2018 Jun 3;27(3):247-256. Epub 2018 May 3.

c College of Biology, Medicine & Environment, The Australian National University , Canberra , Australia.

Background: University students experience high levels of mental health problems; however, very few seek professional help. Teaching staff within the university are well placed to assist students to seek support.

Aims: To investigate university teaching staff experiences of, and training needs around, assisting students with mental health problems.

Method: A total of 224 teaching staff at the Australian National University completed an anonymous online survey (16.4% response rate from n ∼ 1370). Data on mental health training needs, and experiences of assisting students with mental health problems were described using tabulation. Qualitative data were analysed using thematic analysis.

Results: Most teaching staff (70.1-82.2%) reported at least moderate confidence in their ability to provide emotional support for students. However, many staff (60.0%) felt under-equipped overall to deal with student mental health problems; almost half (49.6%) reported they did not have access to formal training. Specific actions described in assisting students included referrals, offering support, or consulting others for advice.

Conclusion: Given the high rates of students who approach staff about mental health problems, there is a critical need to provide and promote both formal mental health response training and explicit guidelines for staff on when, how, and where to refer students for help.
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June 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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January 2017

From Help-Seekers to Influential Users: A Systematic Review of Participation Styles in Online Health Communities.

J Med Internet Res 2015 Dec 1;17(12):e271. Epub 2015 Dec 1.

National Institute for Mental Health Research, Research School of Population Health, The Australian National University, Acton, Australia.

Background: Understanding how people participate in and contribute to online health communities (OHCs) is useful knowledge in multiple domains. It is helpful for community managers in developing strategies for building community, for organizations in disseminating information about health interventions, and for researchers in understanding the social dynamics of peer support.

Objective: We sought to determine if any patterns were apparent in the nature of user participation across online health communities.

Methods: The current study involved a systematic review of all studies that have investigated the nature of participation in an online health community and have provided a quantifiable method for categorizing a person based on their participation style. A systematic search yielded 20 papers.

Results: Participatory styles were classified as either multidimensional (based on multiple metrics) or unidimensional (based on one metric). With respect to the multidimensional category, a total of 41 different participation styles were identified ranging from Influential Users who were leaders on the board to Topic-Focused Responders who focused on a specific topic and tended to respond to rather than initiate posts. However, there was little overlap in participation styles identified both across OHCs for different health conditions and within OHCs for specific health conditions. Five of the 41 styles emerged in more than one study (Hubs, Authorities, Facilitators, Prime Givers, and Discussants), but the remainder were reported in only one study. The focus of the unidimensional studies was on level of engagement and particularly on high-engaged users. Eight different metrics were used to evaluate level of engagement with the greatest focus on frequency of posts.

Conclusions: With the exception of high-engaged users based on high post frequency, the current review found little evidence for consistent participatory styles across different health communities. However, this area of research is in its infancy, with most of the studies included in the review being published in the last 2 years. Nevertheless, the review delivers a nomenclature for OHC participation styles and metrics and discusses important methodological issues that will provide a basis for future comparative research in the area. Further studies are required to systematically investigate a range of participatory styles, to investigate their association with different types of online health communities and to determine the contribution of different participatory styles within and across online health communities.
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December 2015

Online Peer-to-Peer Support for Young People With Mental Health Problems: A Systematic Review.

JMIR Ment Health 2015 Apr-Jun;2(2):e19. Epub 2015 May 19.

National Institute for Mental Health Research The Australian National University Canberra Australia.

Background: Adolescence and early adulthood are critical periods for the development of mental disorders. Online peer-to-peer communication is popular among young people and may improve mental health by providing social support. Previous systematic reviews have targeted Internet support groups for adults with mental health problems, including depression. However, there have been no systematic reviews examining the effectiveness of online peer-to-peer support in improving the mental health of adolescents and young adults.

Objective: The aim of this review was to systematically identify available evidence for the effectiveness of online peer-to peer support for young people with mental health problems.

Methods: The PubMed, PsycInfo, and Cochrane databases were searched using keywords and Medical Subject Headings (MeSH) terms. Retrieved abstracts (n=3934) were double screened and coded. Studies were included if they (1) investigated an online peer-to-peer interaction, (2) the interaction discussed topics related to mental health, (3) the age range of the sample was between 12 to 25 years, and (4) the study evaluated the effectiveness of the peer-to-peer interaction.

Results: Six studies satisfied the inclusion criteria for the current review. The studies targeted a range of mental health problems including depression and anxiety (n=2), general psychological problems (n=1), eating disorders (n=1), and substance use (tobacco) (n=2). The majority of studies investigated Internet support groups (n=4), and the remaining studies focused on virtual reality chat sessions (n=2). In almost all studies (n=5), the peer support intervention was moderated by health professionals, researchers or consumers. Studies employed a range of study designs including randomized controlled trials (n=3), pre-post studies (n=2) and one randomized trial. Overall, two of the randomized controlled trials were associated with a significant positive outcome in comparison to the control group at post-intervention. In the remaining four studies, peer-to-peer support was not found to be effective.

Conclusions: This systematic review identified an overall lack of high-quality studies examining online peer-to-peer support for young people. Given that peer support is frequently used as an adjunct to Internet interventions for a variety of mental health conditions, there is an urgent need to determine the effectiveness of peer support alone as an active intervention.
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November 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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June 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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August 2015