Hypnotherapy for chronic pelvic pain: A scoping systematic review and meta-analysis.

BACKGROUND: Chronic pelvic pain (CPP) is typically managed with anti-inflammatory analgesics and opioids; however, these do not adequately manage the pain or address the associated negative impact on quality of life. Hypnotherapy has been found to reduce pain associated with a range of disorders, including some with symptoms of chronic pain. AIM: The aim of this review is to systematically scope research investigating the use of hypnosis on chronic pelvic pain, quality of life, anxiety, depression and fatigue. METHOD: The scoping review was guided by the method described by Arksey and O'Mallee [1]. A systematic search was conducted in six databases. The Covidence Risk of Bias tool and the National Institutes of Health (NIH) quality assessment tool were used. RESULTS: Nine studies (four RCT's and five case series) were suitable for inclusion. Meta-analysis of the RCT's found no significant difference in pain or quality of life for the intervention group compared to controls. Only one study reported a reduction in pain after hypnotherapy and did not outperform controls. These results are limited due to lack of a standardised intervention and heterogeneity of the included studies. CONCLUSION: There is a need for further research using well designed randomized controlled trials with validated measures of pain, quality of life, anxiety, depression and fatigue. Hypnotherapy interventions utilised in further research should be grounded in evidence-based best practice for dealing with pain.

It's gone, it's back: A prospective study on the COVID-19 pandemic-related shortages and mental health of Australian families.

Our aim was to explore the association between COVID-19 pandemic-related product shortages and symptoms of stress, anxiety, and depression in Australian families, concurrently and longitudinally, while controlling for demographic, health, and psychological characteristics. This prospective study used two waves of data (baseline, Time 0 = April 2020; Time 1 = May 2020) from a longitudinal cohort study of Australian parents of a child aged 0-18 years. Parents were surveyed at baseline about whether they had experienced product shortages related to COVID-19. DASS21 was used to measure symptoms of depression, anxiety, and stress at both waves. The sample included 2,110 participants (N = 1,701, 80.6% mothers). About 68.6% of the respondents reported being impacted by one or more shortages. Product shortages correlated significantly with higher combined and individual scores for anxiety, depression, and stress (r = 0.007 to 0.18, all p < 0.001) at baseline. At Time 1, parental emotion regulation explained 4.0% of the variance (p < .001). Our findings suggest a role for improving parental emotion regulation in coping with stressors, such as shortages and lockdowns.

Acceptance commitment therapy (ACT) for psychological distress associated with inflammatory bowel disease (IBD): protocol for a feasibility trial of the ACTforIBD programme.

INTRODUCTION: Inflammatory bowel disease (IBD) involves an abnormal immune response to healthy gut bacteria. When a person develops IBD, their susceptibility to anxiety and/or depression increases. The ACTforIBD programme, specifically designed for people with IBD and comorbid psychological distress, draws on acceptance and commitment therapy (ACT), which promotes acceptance of situations that cannot be solved such as persistent physical symptoms. There are no ACT trials for IBD using an active control group or a telemedicine approach, which is important to improve accessibility, particularly in the context of the ongoing COVID-19 pandemic. The ACTforIBD programme is administered online with a 4-hour therapist involvement per participant only; if successful it can be widely implemented to improve the well-being of many individuals with IBD. METHODS AND ANALYSIS: Our team have codesigned with consumers the ACTforIBD programme, an 8-week intervention of 1-hour sessions, with the first three sessions and the last session delivered one-to-one by a psychologist, and the other sessions self-directed online. This study aims to evaluate the feasibility and preliminary efficacy of ACTforIBD to reduce psychological distress in patients with IBD. Using a randomised controlled trial, 25 participants will be randomised to ACTforIBD, and 25 patients to an active control condition. ETHICS AND DISSEMINATION: This protocol has been approved by Deakin University Research Ethics Committee in September 2021 (Ref. 2021-263) and the New Zealand Central Health and Disability Ethics Committee in December 2021 (Ref. 2021 EXP 11384). The results of this research will be published in peer-reviewed journals and shared with various stakeholders, including community members, policy-makers and researchers, through local and international conferences. TRIAL REGISTRATION NUMBER: ACTRN12621001316897.

Can an online expressive writing program support people with inflammatory bowel disease? A feasibility randomised controlled trial.

BACKGROUND: We explored feasibility, acceptability and preliminary efficacy of an online writing intervention (WriteforIBD) against an active control condition for distress in people with inflammatory bowel disease (IBD) at the time of the COVID-19 pandemic. METHODS: A feasibility RCT was conducted in 19 adults (89.5% female, aged 20-69 years) with IBD and mild-moderate distress. Participants allocated to the WriteForIBD group completed a 4-day 30-min writing program adapted for IBD. The active control group wrote about trivial topics provided by researchers. Feasibility was established based on the recruitment and retention while acceptability based on completion rates and a numeric rating scale. All participants completed measures of mental health and disease activity before and after the intervention (one week) and at follow-up three months after the study commencement. RESULTS: The retention rate in the study was high (100% WriteForIBD; 82% control). All participants attended every session. 84.2% of participants were satisfied with the intervention. All participants reported a significant improvement in IBD-Control immediately after the intervention; F (2, 33.7) = 7.641, p = .002. A significant interaction of group*time for resilience was noted, R2 = 0.19, p < .001, with the active control group reporting a significant decline in resilience from the first follow-up to three months while no significant change in resilience for the WriteForIBD group was recorded. CONCLUSIONS: Online expressive writing is potentially feasible and highly acceptable to people with IBD who report distress. Future large-scale trials should explore the intervention that is adapted from this feasibility study. REGISTRATION: ID: ACTRN12620000448943p.

Child and Parent Physical Activity, Sleep, and Screen Time During COVID-19 and Associations With Mental Health: Implications for Future Psycho-Cardiological Disease?

The COVID-19 pandemic has afforded the opportunity for some to improve lifestyle behaviours, while for others it has presented key challenges. Adverse changes in global lifestyle behaviours, including physical activity, sleep, and screen time can affect proximal mental health and in turn distal cardiovascular outcomes. We investigated differences in physical activity, sleep, and screen time in parents and children during early stages of the COVID-19 pandemic in Australia compared to pre-COVID-19 national data; and estimated associations between these movement behaviours with parent and child mental health. Cross-sectional baseline data from the COVID-19 Pandemic Adjustment Study (CPAS; N = 2,365) were compared to nationally representative pre-pandemic data from the Longitudinal Study of Australian Children (LSAC; N = 9,438). Participants were parents of children aged ≤ 18 years, residing in Australia. Parents provided self-report measures of mental health, physical activity and sleep quality, and reported on child mental health, physical activity and screen time. Children in CPAS had significantly more sleep problems and more weekend screen time. Their parents had significantly poorer sleep quality, despite increased weekly physical activity. Children's sleep problems were significantly associated with increased mental health problems, after accounting for socioeconomic status, physical activity, and screen time. Poorer parent sleep quality and lower levels of physical activity were significantly associated with poorer mental health. Monitoring this cohort over time will be important to examine whether changes in movement behaviour are enduring or naturally improve with the easing of restrictions; and whether these changes have lasting effects on either parent or child mental health, and in turn, future risk for CVD.

Parent and child mental health trajectories April 2020 to May 2021: Strict lockdown versus no lockdown in Australia.

OBJECTIVE: To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world's first long and strict lockdowns over July-October 2020, while the rest of Australia experienced 'COVID-normal' with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, individual and COVID-19-related factors associated with mental health trajectories. METHODS: Online community sample of 2004 Australian parents with rapid repeated assessment over 14 time-points over April 2020 to May 2021. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (four items from Brief Spence Children's Anxiety Scale). RESULTS: Mental health trajectories shadowed COVID-19 infection rates. Victorians reported a peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardized regression coefficient [ß] = 0.09-0.46), parent/child diagnoses (ß = 0.07-0.21), couple conflict (ß = 0.07-0.18) and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (ß = 0.12-0.15), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers (https://lingtax.shinyapps.io/CPAS_trend/). CONCLUSION: Our findings provide evidence of worse trajectories of parent and child mental health symptoms at a time coinciding with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early on in future lockdowns.

Developmental gains and losses during parenthood.

The onset of parenthood irrevocably changes the landscape of adults' functioning, amplifying the potential for parents' experiences of both developmental losses and gains/growth, in context of increased responsibilities and more limited access to environmental resources/supports. In this article, we draw on dual theoretical lenses to integrate the frameworks of Baltes' lifespan development theory of gains and loss and Bronfenbrenner's bioecological model. We summarize empirical evidence in relation to a normative transition, exemplified by the transition to parenthood, and a non-normative event, the Coronavirus (COVID-19) pandemic, and show that parents' experiences of developmental loss and gains/growth are inextricably linked. Our findings illustrate how parents' losses/gains are influenced by a broad range of individual and environmental factors, with implications for parent prevention/intervention programs.

"I'm in iso all the time anyway": A mixed methods study on the impact of COVID-19 on women with endometriosis.

OBJECTIVE: The COVID-19 pandemic has resulted in restrictions and social isolation measures, which carry mental health risks. Cancellation of surgery and appointments, medication shortages and fear of the virus itself may have further challenged wellbeing. We aimed to understand how COVID-19 has affected people with endometriosis. METHODS: Using a mixed methods design, we examined; 1) the impact of COVID-19 on endometriosis related healthcare, symptoms and functioning; and 2) the relationship between a measure of fear of COVID-19 and qualitative impact in 162 women with endometriosis. RESULTS: We found that 60% of women reported impact of the pandemic upon healthcare, with sub-themes documenting the difficulty of cancelled and delayed treatment, specific COVID-19 barriers, and the advantages and disadvantages of telehealth. Only 23% reported negative impact on symptoms, specifically stress; 76% reported impact on daily functioning, with sub-themes related to compromised work, social life and healthy living. A 'hidden benefits' theme revealed ways that COVID-19 had improved some women's lives, including working from home, and the opportunity for healthy lifestyle choices. Logistic regressions revealed that fear of COVID-19 significantly predicted impact themes (healthcare odds ratio = 0.93, 95% confidence interval: 0.87-0.98; symptoms odds ratio = 0.88, 95% confidence interval: 0.82-0.95; functioning odds ratio = 0.92, 95% confidence interval: 0.85-0.99). CONCLUSION: Our findings indicate the need to provide patients with supportive care during pandemic restrictions that leverage self-management strategies.

Finding the power within and without: How can we strengthen resilience against symptoms of stress, anxiety, and depression in Australian parents during the COVID-19 pandemic?

OBJECTIVE: The present study investigated the association between resilience and indicators of mental health in a large sample of Australian parents at the time of the COVID-19 pandemic. METHODS: Data were from a large longitudinal cohort study of Australian parents of a child aged 0-18 years collected during the COVID-19 pandemic. The Brief Resilience Scale (BRS) was used to measure resilience, the Depression Anxiety and Stress Scale (DASS) measured distress (i.e., composite of stress, anxiety and depression scales). Other factors assessed included: age, gender, being born overseas, number of children, self-assessed introversion, social, educational and economic variables, family resources, positive affect and emotional regulation, external social support, and partner social support. Hierarchical regression models and a moderation analysis were used to assess the aims. RESULTS: Of 2110 parents, 1701 (80.6%) were female. The mean age was 38 years old (SD = 7, range = 19-69). High loneliness was a key contributor to distress. The level of social support received did add significantly to distress, with greater assistance associated with lower stress and anxiety (both p < .01). Partner support significantly moderated the relationship between resilience and depression; however, this relationship is of unlikely clinical significance due to its small statistical effect. CONCLUSION: Interventions targeting resilience against distress and mental health of parents at the time of pandemics should focus on reducing loneliness while working with the constraints of imposed social isolation and might include partners. Qualitative studies are needed to understand the various useful and not useful aspects of partner's support.

From "It Has Stopped Our Lives" to "Spending More Time Together Has Strengthened Bonds": The Varied Experiences of Australian Families During COVID-19.

The present study uses a qualitative approach to understand the impact of COVID-19 on family life. Australian parents of children aged 0-18 years were recruited via social media between April 8 and April 28, 2020, when Australians were experiencing social distancing/isolation measures for the first time. As part of a larger survey, participants were asked to respond via an open-ended question about how COVID-19 had impacted their family. A total of 2,130 parents were included and represented a diverse range of family backgrounds. Inductive template thematic analysis was used to understand patterns of meaning across the texts. Six themes were derived from the data, including "Boredom, depression and suicide: A spectrum of emotion," "Families are missing the things that keep them healthy," "Changing family relationships: The push pull of intimacy," "The unprecedented demands of parenthood," "The unequal burden of COVID-19," and "Holding on to positivity." Overall, the findings demonstrated a breadth of responses. Messages around loss and challenge were predominant, with many families reporting mental health difficulties and strained family relationships. However, not all families were negatively impacted by the restrictions, with some families reporting positive benefits and meaning, including opportunities for strengthening relationships, finding new hobbies, and developing positive characteristics such as appreciation, gratitude, and tolerance.

Expressive writing to combat distress associated with the COVID-19 pandemic in people with inflammatory bowel disease (WriteForIBD): A trial protocol.

OBJECTIVE: A large proportion of patients with inflammatory bowel disease (IBD) receive immunosuppressive medication, may be at higher risk of complications if they contract SARS-CoV-2 virus, and therefore report high levels of COVID-19-related distress. This trial will evaluate a brief, evidence-based, online, group-based expressive writing intervention to reduce COVID-19-related distress in people living with IBD at the time of pandemic. METHODS: A parallel double-blind randomised controlled trial will be conducted. Overall, up to 154 adult participants with IBD and mild-moderate distress will be recruited via patient organisations. Participants will be allocated to the expressive writing intervention or an active control group. All participants will complete questionnaires including measures of distress, quality of life, resilience, self-efficacy, social support and disease activity before and after the intervention (1 week) and at 3 months post-intervention. The expressive writing group will participate in the evidenced-based 4-day writing program adapted from Pennebaker and Beall, 1986. The active control group will write about untherapeutic topics provided by researchers. Statistical analysis will be carried out on an intention-to-treat basis and will involve linear mixed effects models. CONCLUSIONS: If successful, this simple intervention may bring personal and societal benefits, particularly because it is low cost, can be easily implemented online, ensuring social distancing, and be made widely available, during future disasters and to help with trauma-related distress in IBD. TRIAL REGISTRATION: The trial has been prospectively registered in the Australian New Zealand Trial Registry - ACTRN12620000448943p.

Study Protocol for the COVID-19 Pandemic Adjustment Survey (CPAS): A Longitudinal Study of Australian Parents of a Child 0-18 Years.

BACKGROUND: The COVID-19 pandemic presents significant risks to the mental health and wellbeing of Australian families. Employment and economic uncertainty, chronic stress, anxiety, and social isolation are likely to have negative impacts on parent mental health, couple and family relationships, as well as child health and development. OBJECTIVE: This study aims to: (1) provide timely information on the mental health impacts of the emerging COVID-19 crisis in a close to representative sample of Australian parents and children (0-18 years), (2) identify adults and families most at risk of poor mental health outcomes, and (3) identify factors to target through clinical and public health intervention to reduce risk. Specifically, this study will investigate the extent to which the COVID-19 pandemic is associated with increased risk for parents' mental health, lower well-being, loneliness, and alcohol use; parent-parent and parent-child relationships (both verbal and physical); and child and adolescent mental health problems. METHODS: The study aims to recruit a close to representative sample of at least 2,000 adults aged 18 years and over living in Australia who are parents of a child 0-4 years (early childhood, N = 400), 5-12 years (primary school N = 800), and 13-18 years (secondary school, N = 800). The design will be a longitudinal cohort study using an online recruitment methodology. Participants will be invited to complete an online baseline self-report survey (20 min) followed by a series of shorter online surveys (10 min) scheduled every 2 weeks for the duration of the COVID-19 pandemic (i.e., estimated to be 14 surveys over 6 months). RESULTS: The study will employ post stratification weights to address differences between the final sample and the national population in geographic communities across Australia. Associations will be analyzed using multilevel modeling with time-variant and time-invariant predictors of change in trajectory over the testing period. CONCLUSIONS: This study will provide timely information on the mental health impacts of the COVID-19 crisis on parents and children in Australia; identify communities, parents, families, and children most at risk of poor outcomes; and identify potential factors to address in clinical and public health interventions to reduce risk.