Dissociation training and symptom identification accuracy among Australian psychologists.

OBJECTIVE: Dissociation is a common but underrecognized sequelae of trauma exposure. We investigated Australian psychologists' training in dissociation, assessment practices, and accuracy in identifying dissociation symptoms. METHOD: Participants in this cross-sectional study of Australian psychologists (N = 280) were recruited through publicly available email addresses, graduate psychology programs, and social media. Participants estimated the percentages of their clients who had experienced trauma and had dissociative symptoms, their confidence in assessing and treating trauma and dissociation, their training in trauma and dissociation, and their dissociation screening practices. Participants were also asked to identify dissociation symptoms (per the Dissociative Experiences Scale-II and Somatic Dissociation Questionnaire-5) from a list of trauma-related symptoms. RESULTS: Although 99% of participants reported treating trauma-exposed clients, only 59.6% and 41.1% reported formal training in trauma or dissociation during their psychology qualification, respectively. One in five participants correctly identified all psychoform and somatoform symptoms as dissociation. Accurately identifying psychoform dissociation symptoms was associated with confidence in treating dissociation (p = .048) and having informal peer consultation on dissociation (p = .032). Accurately identifying somatoform dissociation was associated with confidence assessing (p = .006) and treating (p = .009) dissociation and having completed professional development on dissociation (p = .047). CONCLUSIONS: Most psychologists demonstrated inaccuracies in their knowledge of dissociation, which raises concern that dissociation may not be recognized in clinical practice and thus go untreated. Training on dissociation should be incorporated into psychology curricula, particularly at the graduate level, and accessible, cost-effective professional development programs for practicing clinicians are needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health, Wellbeing and Empowerment E-workshops for Mothers of Children with Disabilities: A Non-randomised Comparison Study.

Mothers of children with disabilities can experience compromised health. Targeted interventions require investigation to determine effectiveness. Healthy Mothers Healthy Families (HMHF) is a health, wellbeing and empowerment program that addresses mothers need to protect, and or, recover their own health due to caregiving impacts. This study compared the effectiveness of HMHF e-workshops online compared to no intervention. The HMHF e-workshops were delivered to 290 mothers across the 2020-2022 Covid-19 pandemic and 172 participated in research. The HMHF e-workshops included 3 online 2- hour workshops facilitated by credentialled peer-facilitators, closed online group chat, e-workbook and online learning package. Participants in both groups completed surveys pre and post the workshops (or control) over 8-10 weeks. Mothers who participated in HMHF significantly increased health help seeking behaviours (p < .001), and improved mental health and health behaviors over time: health behavior (p < .001), positive wellbeing (p < .004) and depression (p < .001) and stress symptoms (p = .005). Compared to controls, HMHF e-workshop participants significantly improved health behaviours (p < .001) and self-reported symptoms of depression (p = .002) and stress (p = .005) over 8-10 weeks. E-workshops were accessible and effective for mothers of children with high care needs and family responsibilities across the COVID-19 pandemic. Compared to no intervention, the HMHF intervention was more effective for improving healthy behaviours and mental health.

Cross-Cultural Validation of the Chinese Version of the Health Promoting Activities Scale.

IMPORTANCE: The Health Promoting Activities Scale (HPAS) measures the frequency of participation in health-promoting activities of mothers of children with disabilities. Translation of the HPAS into Chinese and validation of the Chinese version will enable its use with Chinese-speaking mothers of children with disabilities. OBJECTIVE: To translate the HPAS into Chinese and assess its construct validity in relation to measures of well-being, mental health, and activity satisfaction. DESIGN: Cross-cultural validation. SETTING: Community. PARTICIPANTS: Eight bilingual Chinese speakers were involved in the translation. Ethnic Chinese mothers of children with disabilities living in Australia, Singapore, or Taiwan (N = 89) were recruited via purposive snowball sampling. Participants self-selected to complete the Chinese e-survey. OUTCOMES AND MEASURES: Translation was guided by recommended frameworks. The Chinese versions of the Warwick-Edinburgh Mental Well-being Scale (WEMWS), Personal Well-being Index (PWI), and Kessler Psychological Distress Scale-10 (K10) were used to determine construct validity. Internal reliability was investigated. RESULTS: The Chinese version of the HPAS correlated significantly with satisfaction ratings (r = .45, p < .001; n = 87), WEMWS Total score (r = .61, p < .001; n = 85), PWI mean score (r = .44, p < .001; n = 84), and K10 total score (r = -.33, p = .002; n = 81). Internal reliability was moderate (Cronbach's α = .74). CONCLUSIONS AND RELEVANCE: The Chinese version of the HPAS was found to be cross-culturally equivalent to the original HPAS and psychometrically sound for use with Chinese-speaking mothers of children with disabilities. What This Article Adds: This study provides an example of the cross-cultural validation process. The Chinese version of the HPAS is psychometrically sound and could be used as an outcome measure of Chinese mothers' participation in health-promoting activities.

Initial Development and Evaluation of the My Family's Accessibility and Community Engagement (MyFACE) Tool for Families of Children With Disabilities.

IMPORTANCE: Parental perceptions and experiences of community inclusion influence the community participation of families and children with a disability, although no measurement tools exist. OBJECTIVE: To describe the initial development of the My Family's Accessibility and Community Engagement (MyFACE) tool. DESIGN: MyFACE measures parental perceptions of community accessibility and engagement of families raising a child with a disability. Items represent common community activities rated on a 5-point Likert scale. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guided content validity, construct validity, and internal reliability testing. SETTING: Australia. PARTICIPANTS: Seventy-seven mothers of children with a disability provided data, with 69 complete data sets. RESULTS: The nine-item MyFACE had excellent content and construct validity and good internal reliability (Cronbach's α = .85). Hypothesis testing correlated MyFACE with maternal factors (mental health and healthy behavior) and child factors (psychosocial issues). Three predictors together explained 27% of the variance in a significant model, F(3, 61) = 7.09, p < .001. The most important predictor was maternal depressive symptoms. CONCLUSIONS AND RELEVANCE: Initial evaluation of the MyFACE tool suggests sound psychometric properties warranting further development. What This Article Adds: The MyFACE tool provides clinicians and researchers with a way to measure parental perceptions of community inclusion. Maternal depressive symptoms were predictive of MyFACE scores, indicating that to be effective, family participation may require clinicians to address maternal mental health and children's participation restrictions.

Psychological Interventions to Improve Sleep in Young Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

INTRODUCTION: The effects of impaired sleep on the wellbeing of young adults are profound, and the adverse outcomes for mental health are well documented in the research literature. OBJECTIVE: This systematic review and meta-analysis aimed to identify, summarize, and synthesize the available evidence from randomized-controlled trials (RCTs) investigating psychological interventions aimed at improving sleep and related secondary outcomes such as anxiety and depression in healthy young adults. METHOD: Nine electronic databases (Cochrane Central Registry of Controlled Trials [CENTRAL], PubMed, Scopus, PsycNET, CINHAL, INFORMIT, Web of Science [Science and Social Citation Index], OpenSigle and EMBASE) were searched, returning 54 full-text papers for assessment, with 13 studies meeting inclusion criteria for the meta-analysis. RESULTS: A random effects meta-analysis showed that the combined effect of all interventions was moderate (ES = -0.53, 95% CIs [- 0.69, -0.36], p < .01), reflecting the efficacy of psychological interventions at improving sleep scores at post-intervention. Subgroup analyses of individual interventions showed that cognitive-behavioral interventions improved sleep (ES = -0.67, 95% CIs [-0.77, -0.57], p < .01) and secondary outcomes for anxiety (ES = -0.35, 95% CIs [-0.56, -0.15], p < .01) and depression (ES = -0.41, 95% CIs [-0.70, -0.13], p < .01) at post-intervention. CONCLUSION: The results of the current review support the implementation of cognitive and behavioral interventions for sleep among young adults experiencing both sleep and comorbid mental health problems.

Mental Health and Health Behaviour Changes for Mothers of Children with a Disability: Effectiveness of a Health and Wellbeing Workshop.

Healthy Mothers Healthy Families (HMHF) is a program that educates and empowers mothers of children with disabilities to improve health behaviours. Outcomes were investigated in this study. A pre, post-test design was implemented using online questionnaires including the Health promoting activities scale (HPAS) and the Depressional anxiety stress scales (DASS). Mothers (N = 71) experienced improvements in HPAS scores, p < .001. Mental health symptomatology reduced: depressive symptoms (p = .005), Anxiety symptoms (p = .005) and stress (p = .002). Wellbeing improved (p < .001). Mothers also reported that their child with a disability experienced an increase in quality of life (p = .042). Mothers' lifestyles goals improved: managing stress; dietary changes; leisure; self-perception and others. HMHF is an effective intervention with improved health status and outcomes for mothers.

Profile of Mothers of Children with a Disability Who Seek Support for Mental Health and Wellbeing.

This paper investigated the characteristics of mothers of children with a disability who registered for a mental health and wellbeing workshop. The questionnaire measured mental health, health-related behaviours, empowerment, family cohesion, wellbeing and child-related variables. Regression analysis identified factors associated with depressive symptoms and positive wellbeing. Fifty-seven percent of participants (N = 171) had depressive symptoms within the clinical range. Higher symptoms were associated with reduced: empowerment (r = - .39, p < .01); positive-wellbeing (r = - .66, p < .05); and healthy activity (r = - .41, p < .001). Low positive wellbeing (ß = .55, p < .001) was the strongest predictor of depressive symptoms. Family cohesion (ß = .25, p < .001), was the strongest predictor of positive-wellbeing. Future health and wellbeing interventions that support mothers with high care responsibilities should include psycho-education and strategies to address healthy maternal and family-related behaviour changes.

Maternal and child factors associated with the health-promoting behaviours of mothers of children with a developmental disability.

BACKGROUND/AIM: Mothers caring for their child or adult with a developmental disability can experience mental health disparity. Protective factors such as healthy behaviours are under-researched. This study investigated relationships between mental health, healthy behaviours, and disability factors. METHODS: The cross-sectional online survey included: Depression Anxiety Stress Scales (DASS); Family Empowerment Scale (FES); Health Promoting Activities Scale (HPAS); and a measure of childhood quality of life (QoL). RESULTS: All mothers were raising offspring (aged 3-36 years) with a developmental disability. Fifty-two percent of mothers (N = 81) had a mental health diagnosis. DASS scores were elevated for depression (58 %), anxiety (52 %) and stress (68 %). Mothers participated in health promoting activities infrequently and reported low satisfaction with community health-supporting facilities. Depressive symptoms, maternal empowerment and two indicators of child-related QoL explained 29.7 % of the variance in healthy behaviours. Depressive symptoms were the most important predictor of lack of health promoting behaviours. CONCLUSIONS: Better mental health predicted more frequent participation in health promoting behaviour. Future research might explore the extent to which health promoting behaviours protect mental health. Service changes including family health focused services, and custom designed health promotion or coaching programs may improve the health behaviours of mothers with high care responsibilities.

Further psychometric evaluation of the My Family's Accessibility and Community Engagement (My FACE) tool: Mothers' ratings of perceptions of community accessibility and engagement for their child with disabilities.

BACKGROUND/AIM: My Family's Accessibility and Community Engagement (My FACE) measures mothers' perceptions of community accessibility and engagement for families raising children with a disability. This study investigated the construct validity including the factor structure and internal reliability of the MyFace scale. METHODS: Construct validity was evaluated using hypothesis testing. Structural validity was confirmed with factor analysis. Internal reliability was measured using Cronbach alpha. The nine-item MyFACE includes items representing common community destinations. A 5-point Likert scale measured perceptions of need for change and inclusion. RESULTS: Mothers (N = 83) completed an online survey with MyFACE, maternal and childhood disability scales. Hypothesis testing revealed correlations with MyFACE: Depression Anxiety Stress Scales (DASS)-stress (r = -.25, n = 72, p = .037), DASS-anxiety (r = -.41, n = 70, p < .001,), and DASS-depression (r = -.27, n = 72, p = .023,) scales. MyFACE scores correlated with mothers' total Health Promoting Activity Scale (HPAS) scores (r = .40, n = 74, p < .001). HPAS was the strongest predictor of variation in MyFACE scores F(5, 66) = 5.68, p < .001. Factor analysis demonstrated unidimensionality. Internal reliability was excellent (Cronbach alpha = .80). CONCLUSIONS: The MyFACE tool is psychometrically sound. Compared to child factors, maternal mental health and health promoting behaviour had more influence on mothers' perceptions of family community accessibility and engagement. The MyFACE measures a unique, previously unmeasurable family construct.

Interventions to Improve the Mental Health of Mothers of Children with a Disability: Systematic Review, Meta-analysis and Description of Interventions.

To investigate the effectiveness of interventions that aim to improve the mental health of mothers of children with disabilities. Seven databases were searched. Interventions incorporated primarily cognitive-behavioural, psychoeducation, mindfulness or support-group approaches. The Template-for-Intervention-Description-and-Replication guided descriptions. Meta-analyses using a random effect model of randomized controlled trials assessed intervention effects on parenting stress and mental health. Of the 1591 retrieved papers, 31 met criteria to be appraised and 17 were included in the meta-analysis. Cognitive-behavioural approaches reduced parenting stress [2 studies, n = 64, pooled Standardized-Mean-Difference (SMD) = 0.86, 95% CI (0.43, 1.29)] and improved mental health [3 studies, n = 186, pooled SMD = 1.14, 95% CI (0.12, 2.17)], psychoeducation approaches improved mental health [2 studies, n = 165, SMD = 0.60, 95% CI (0.17, 1.03)]. Cognitive-behavioural and psychoeducation interventions are effective. Further research and clinical guidelines are warranted.

Non-pharmacological interventions to prevent hospital or nursing home admissions among community-dwelling older people with dementia: A systematic review and meta-analysis.

Older people with dementia more frequently experience episodes of hospital care, transferal to nursing home and adverse events when they are in these environments. This study synthesised the available evidence examining non-pharmacological interventions to prevent hospital or nursing home admissions for community-dwelling older people with dementia. Seven health science databases of all dates were searched up to 2 December 2019. Randomised controlled trials and comparative studies investigating non-pharmacological interventions for older people with dementia who lived in the community were included. Meta-analyses using a random-effect model of randomised controlled trials were used to assess the effectiveness of interventions using measures taken as close to 12 months into follow-up as reported. Outcomes were risk and rate of hospital and nursing home admissions. Risk ratio (RR) or rate ratios (RaR) with 95% confidence interval were used to pool results for hospital and nursing home admission outcomes. Sensitivity analyses were conducted to include pooling of results from non-randomised trails. Twenty studies were included in the review. Community care coordination reduced rate of nursing home admissions [(2 studies, n = 303 people with dementia and 86 patient-caregiver dyads), pooled RaR = 0.66, 95% CI (0.45, 0.97), I2  = 0%, p = .45]. Single interventions of psychoeducation and multifactorial interventions comprising of treatment and assessment clinics indicated no effect on hospital or nursing home admissions. The preliminary evidence of community care coordination on reducing the rate of nursing home admissions may be considered with caution when planning for community services or care for older people living with dementia.

Measuring Self-Esteem Changes in Children and Adolescents Affected by Overweight or Obesity: A Scoping Review of Instruments Currently Used in Multicomponent Weight-Management Interventions.

Purpose: Children and adolescents affected by overweight or obesity are at risk of greater declines in self-esteem than healthy-weight individuals. Participation in multicomponent weight-management programs can positively influence self-esteem in children and adolescents affected by overweight or obesity; however, the variety of questionnaires used to assess self-esteem makes it difficult to compare changes across and identify effective interventions. This review identified and critically examined questionnaires currently used for monitoring self-esteem in children and adolescents. Methods: An electronic search, from 2007 onward, identified multicomponent weight-management interventions that included a measure of self-esteem. A second search identified studies that reported validation assessment of the questionnaires identified in search one. Results: Seven validated self-esteem questionnaires were employed across the 36 studies identified in search one, including (in descending order of use) Harter's Self-Perception Profiles for children and adolescents, Rosenberg Self-Esteem Scale, Marsh's Self-Description Questionnaire-I, Beck Youth Inventory II, Piers-Harris Self-Concept Scale, and Children and Youth Physical Self-Perception Profile. These tools measured global self-esteem (n = 1) as well as self-esteem as a series of subscales (multidimensional), such as physical appearance and social competence (n = 6). Conclusions: In the absence of changes in global self-esteem, multidimensional tools allow the examination of domains of self-esteem. The Harter's Self-Perception Profile for Children (SPPC) and adolescents questionnaire is an example of a tool that encompasses multidimensional aspects of self-esteem and global self-esteem and is appropriate for younger and older aged children and adolescents.

Pragmatic, Randomized Controlled Trials of the Girls on the Go! Program to Improve Self-Esteem in Girls.

PURPOSE: To test the effectiveness of an intervention delivered by health professionals outside the school environment to girls identified with issues such as poor body image, low self-esteem, low self-confidence, nonparticipation in sports, or being overweight or underweight. DESIGN: The study's design was a stepped-wedge randomized controlled trial to test the efficacy of an intervention on self-esteem, impairment induced by eating disorders, self-efficacy, body satisfaction, and dieting behaviors. SETTING: The study took place at the community health center located in a culturally diverse area of Melbourne, Victoria, Australia. SUBJECTS: Participants were 122 primary and secondary school girls between 10 and 16 years of age. INTERVENTION: Girls on the Go! is a 10-week program designed to improve self-esteem, body image, and confidence, using an empowerment model that involved interactive and experiential learning approaches. Weekly themes included body image and self-esteem, safety and assertiveness, a healthy mind, physical activity, healthy eating, trust and confidence, and connections. MEASURES: Measurements were made using Rosenberg Self-Esteem Scale, clinical interview assessment, health self-efficacy (included mental health and physical health self-efficacy scales), body esteem scale, and the Dutch Eating Behavior Questionnaire for Children. ANALYSIS: A linear mixed model was used. RESULTS: The intervention led to a significant increase (p < .05) in self-esteem and self-efficacy (mental and physical health self-efficacy subscales), for both primary and secondary school-aged participants and reduced dieting behaviors (secondary school participants). These gains were retained after 6 months of follow-up. CONCLUSION: This group-based, low-dose intervention, which, although targeting girls with a range of psychological issues and including both overweight and underweight participants, is a successful means of improving self-esteem among girls from diverse cultural backgrounds.

Investigation of the effectiveness of the "Girls on the Go!" program for building self-esteem in young women: trial protocol.

BACKGROUND: Body Image is a major factor affecting health in a range of age groups, but has particular significance for adolescents. The aim of this research is to evaluate the efficacy of the "Girls on the Go!" program delivered outside of the school environment by health professionals to girls at risk of developing poor self-esteem on the outcomes of self-esteem, impairment induced by eating disorders, body satisfaction, self-efficacy, and dieting behaviour. METHOD: A stepped wedge, cluster randomised controlled trial that was conducted in two phases on the basis of student population (Study 1 = secondary school age participants; Study 2 = primary school age participants). The waiting list for the "Girls on the Go!" program was used to generate the control periods. A total of 12 schools that requested the program were separated into study 1 or 2 on the basis of student population (Study 1 = secondary, Study 2 = primary). Schools were matched on the basis of number of students and were allocated to receiving the intervention immediately or having a waiting list period. Study 1 had one waiting list period of one school term, creating two steps in the stepped-wedge design (i.e. 3 schools were provided with "Girls on the Go!" each term over 2 terms). Study 2 had two waiting list periods of one and two school terms, creating three steps in the stepped-wedge design (i.e. 2 schools were provided with "Girls on the Go!" each term over 3 terms). Primary outcome measures were self-esteem and impairment inducted by eating disorders. DISCUSSION: There is a lack of preventative interventions currently available that address low self-esteem, low self-efficacy and body dissatisfaction in young women. This project will be the first group-based, professional-led, targeted program conducted outside the school environment amongst school age young women to be evaluated via a randomised control trial. These findings will indicate if the "Girls on the Go!" program may be successfully used and applied in a culturally diverse environment and with young women of all shapes and sizes. TRIAL REGISTRATION: (ACTRN12610000513011).