"I don't have time": an exploration of the role of time pressures in acceptance of internet interventions for mental health.

BACKGROUND: Internet interventions for common mental disorders are widely available, effective, and economical, yet community uptake remains low. One consistently cited reason for not engaging in mental health interventions is lack of time. AIMS: This research examined whether lack of time as a rationale for not using online interventions reflects real time scarcity, and whether time availability impacts intention to use interventions. METHODS: A nationally representative sample (N = 1094, 51% women) reported their time use in activity categories for a typical week. Participants rated their acceptance and likelihood of use of mental health internet interventions, and completed mental health symptom, help-seeking and stigma measures. RESULTS: Amount of leisure time reported by participants was not associated with acceptance or likelihood of use of internet interventions for mental health. However, respondents who worked longer hours ranked time and effort factors as more influential in their intention to use internet-based mental health programs. Younger respondents and those with greater help-seeking attitudes reported higher acceptance of use. CONCLUSION: These findings suggest lack of time is not a direct barrier to use of internet interventions, and that perceived time scarcity may be masking real barriers to uptake.

Specific anxiety and depression symptoms are risk factors for the onset of suicidal ideation and suicide attempts in youth.

BACKGROUND: Suicidality research has typically focused on affective disorders to identify at-risk youth. Investigating the predictive role of individual symptoms, particularly anxiety symptoms, may allow for preventative targeting of additional risk factors for suicidal ideation and attempts. METHODS: This analysis used the Sources of Strength Australia project dataset, a cluster randomised controlled trial which assessed the impact of a schools-based intervention for youth help-seeking over 18 months (Calear et al., 2022). Symptoms of anxiety, depression and distress at baseline were used to predict the onset of suicidal ideation, planning for suicide and suicide attempts at 18 months. RESULTS: Worry, lack of sleep and anxiety interfering with everyday activities at baseline predicted new onset of suicidal ideation 18 months later. Worry about the future and past, reduced appetite and a belief that life wasn't worth living were risk factors for later suicide plans and attempts. Total scale scores on the scales were typically poor predictors of onset of suicidal behaviours. LIMITATIONS: Analyses were impacted by dropouts over the 18 month study period and restricted further investigation into potential behaviour transition trajectories. CONCLUSIONS: These findings identify individual symptom profiles associated with later onset of suicidal behaviour. Broadening the focus beyond depression and hopelessness to incorporate anxiety, worry and reduced sleep as risk factors for suicidality is important for public health and clinical settings.

Characteristics of episodic future thinking in anxiety: A systematic review and meta-analysis.

Deficits in episodic future thinking (EFT) characteristics such as detail/vividness, specificity and the use of mental imagery are associated with psychopathology. However, whether these characteristics are associated with anxiety is not well understood. This article reports a systematic review and meta-analysis of research examining associations between anxiety and these EFT characteristics. Peer-reviewed studies that are published in the English language and contain at least one measure of anxiety and one measure of EFT characteristics were screened for inclusion in APAPsychINFO, CINAHL Plus and MEDLINE. Twenty-nine studies met the inclusion criteria. Results indicated that anxiety was not significantly correlated with detail/vividness overall. However, this was qualified by a moderating effect of cue valence. This finding is consistent with the Attentional Control and Contrast Avoidance Theories of anxiety, whereby higher anxiety is related to high detail/vividness in future thinking in the context of negatively-valenced cues, and conversely lower detail/vividness for positively-valenced cues. Anxiety was not significantly associated with specificity or the use of mental imagery. While heterogeneity and the low number of studies examining particular associations limited the findings, the results provide insight into the current state of the field and have both theoretical and clinical implications.

Measuring psychological and physiological stress in emergency clinicians.

BACKGROUND: Evidence regarding stress, team structure and decision-making has been used to inform efficacious team composition and deployment. There have been limited attempts to establish the relationship between psychological stress with physiological data within professional environments. The current study explored measures of psychological and physiological stress in Australian emergency practitioners. METHODS: Thirty-seven staff in an Australian emergency department completed an online survey assessing freedom to make decisions, social support, and psychological job demands. Seven participants provided saliva samples three times daily for seven days (valid n=141 samples). Cortisol levels of the samples were analysed using competitive enzyme immunoassay kits, and α-amylase using kinetic enzyme assay kits. RESULTS: Years of emergency experience was positively associated with freedom to make decisions, and social support was negatively correlated with psychological demand. No consistent pattern was observed between cortisol level and reported psychological demand, decision freedom or social support. Physical activity was not reflected in elevated α-amylase. Diurnal variation of cortisol and α-amylase was not affected by shiftwork. CONCLUSIONS: The data supports the case for using multiple assessments to measure stress. While the psychological data is consistent with previous findings, there are possible disparities between psychological reports and physical indicators of stress.

Manipulating the Valence of Future Thought: The Effect on Affect.

Imagining personal future events is associated with well-being, but the nature and direction of this relationship are unclear. This study investigated whether imagining episodic future scenarios, experimentally manipulated for valence, have an immediate impact on affect. University students (N = 197) completed a 2 × 3 between-subject online study in which they imagined four personal events likely to occur in the future. Participants were directed to imagine positive or negative events or were undirected as to valence to additionally assess the valence and effect of self-directed imagined scenarios. Participants in all three conditions reported a change in positive affect immediately after the task, with both positive and nondirected thinking improving positive affect and negative future thoughts reducing it. However, negative affect only shifted in response to negative future thinking but not the other conditions. These findings demonstrate that there is an immediate causal effect of episodic future thinking on affect but only in specific directions and that this differs from the patterns shown in longer term measurements. The findings also suggest when self-directed that imagined future thoughts tend to mirror the valence and causal effect of positively induced thoughts. This study has implications for the ongoing debate around future thinking and well-being.

Detecting Temporal Cognition in Text: Comparison of Judgements by Self, Expert and Machine.

Background: There is a growing research focus on temporal cognition, due to its importance in memory and planning, and links with psychological wellbeing. Researchers are increasingly using diary studies, experience sampling and social media data to study temporal thought. However, it remains unclear whether such reports can be accurately interpreted for temporal orientation. In this study, temporal orientation judgements about text reports of thoughts were compared across human coding, automatic text mining, and participant self-report. Methods: 214 participants responded to randomly timed text message prompts, categorically reporting the temporal direction of their thoughts and describing the content of their thoughts, producing a corpus of 2505 brief (1-358, M = 43 characters) descriptions. Two researchers independently, blindly coded temporal orientation of the descriptions. Four approaches to automated coding used tense to establish temporal category for each description. Concordance between temporal orientation assessments by self-report, human coding, and automatic text mining was evaluated. Results: Human coding more closely matched self-reported coding than automated methods. Accuracy for human (79.93% correct) and automated (57.44% correct) coding was diminished when multiple guesses at ambiguous temporal categories (ties) were allowed in coding (reduction to 74.95% correct for human, 49.05% automated). Conclusion: Ambiguous tense poses a challenge for both human and automated coding protocols that attempt to infer temporal orientation from text describing momentary thought. While methods can be applied to minimize bias, this study demonstrates that researchers need to be wary about attributing temporal orientation to text-reported thought processes, and emphasize the importance of eliciting self-reported judgements.

Team structure, skill mix and clinical outcomes.

The majority of presentations to Australian EDs are for semi-urgent and non-urgent complaints in the older adult. For these patient's treatment and care is typically delivered by loosely organised teams of professionals. While substantial research has examined the clearly defined, hierarchical team structures used during resuscitation events, little is known about the composition and functioning of teams involved in non-urgent patient care in ED. Investigation of these team dynamics can identify personal and professional factors involved in the delivery of this care and enable the design of teams that enhance patient outcomes.

A systematic review of psychosocial suicide prevention interventions for youth.

Youth suicide is a significant public health problem. A systematic review was conducted to examine the effectiveness of school, community and healthcare-based interventions in reducing and preventing suicidal ideation, suicide attempts and deliberate self-harm in young people aged 12-25 years. PsycInfo, PubMed and Cochrane databases were searched to the end of December 2014 to identify randomised controlled trials evaluating the effectiveness of psychosocial interventions for youth suicide. In total, 13,747 abstracts were identified and screened for inclusion in a larger database. Of these, 29 papers describing 28 trials fulfilled the inclusion criteria for the current review. The results of the review indicated that just over half of the programs identified had a significant effect on suicidal ideation (Cohen's d = 0.16-3.01), suicide attempts (phi = 0.04-0.38) or deliberate self-harm (phi = 0.29-0.33; d = 0.42). The current review provides preliminary support for the implementation of universal and targeted interventions in all settings, using a diverse range of psychosocial approaches. Further quality research is needed to strengthen the evidence-base for suicide prevention programs in this population. In particular, the development of universal school-based interventions is promising given the potential reach of such an approach.

Suicide prevention in schizophrenia spectrum disorders and psychosis: a systematic review.

BACKGROUND: The incidence of suicide is high among patients with schizophrenia spectrum disorders and psychosis. A systematic review was performed to investigate the effectiveness of psychosocial interventions in reducing suicidal behaviour among patients with schizophrenia spectrum disorders and psychosis. METHODS: Cochrane, PubMed and PsycINFO databases were searched to January 2012. Additional materials were obtained from reference lists. Randomised Controlled Trials describing psychosocial interventions for psychotic disorders with attention placebo, treatment as usual (TAU), no intervention or waitlist control groups were included. RESULTS: In total, 11,521 abstracts were identified. Of those, 10 papers describing 11 trials targeting psychosocial interventions for reducing suicidal behaviour in patients with schizophrenia spectrum disorders and psychosic symptoms or disorders met the inclusion criteria. Odds Ratios describing the likelihood of a reduction in suicidal behaviour or ideation ranged from 0.09 to 1.72 at post-test and 0.13 to 1.48 at follow-up. CONCLUSIONS: Psychosocial interventions may be effective in reducing suicidal behaviour in patients with schizophrenia spectrum disorders and psychosis, although the additional benefit of these interventions above that contributed by a control condition or treatment-as-usual is not clear.