Cognitive-behaviour Therapy For Tinnitus: Dismantling Study To Maximise Treatment Efficacy
Funder
National Health and Medical Research Council
Funding Amount
$230,220.00
Summary
Tinnitus (ringing in the ears) is a problem which affects a large number of people and for which there is no generally successful medical treatment. People are usually told that they will have to learn to live with the problem. Cognitive-behaviour therapy (CBT) has emerged as the principle means of helping people to cope with tinnitus. The proposed study aims to: (a) enhance the efficacy of CBT interventions for tinnitus, (b) identify the active components of CBT that mediate treatment gains, an ....Tinnitus (ringing in the ears) is a problem which affects a large number of people and for which there is no generally successful medical treatment. People are usually told that they will have to learn to live with the problem. Cognitive-behaviour therapy (CBT) has emerged as the principle means of helping people to cope with tinnitus. The proposed study aims to: (a) enhance the efficacy of CBT interventions for tinnitus, (b) identify the active components of CBT that mediate treatment gains, and (c) specify the mechanisms by which change occurs. The study is designed to dismantle the multi-component CBT tinnitus management protocol to investigate the relative efficacy of the individual components of treatment. The need to identify the types of psychological therapies which work best for potentially different kinds of tinnitus patients is important on both practical and theoretical grounds. Identifying and including only those components of treatment that are beneficial, and eliminating those that are not, is crucial to matching specific treatments to specific patients, which represents a major endeavour in contemporary psychotherapy research. Whether there are individual differences in response to the different components of the treatment or whether there is a single most potent component is of considerable theoretical interest. It is expected that subjects who receive the full treatment will display the largest immediate and long-term gains. Treatments which involve cognitive restructuring will produce better effects than those that do not. This project will contribute to enhanced functioning among tinnitus patients and increase the proportion of those who can benefit from empirically supported therapies.Read moreRead less
Age-related Changes In Vision And Cognitive Performance: Are There Cognitive Benefits From Cataract Surgery?
Funder
National Health and Medical Research Council
Funding Amount
$101,074.00
Summary
It is possible that some of the confusion and memory loss experienced by older people is due to perceptual errors resulting from poor vision. If this is the case, then treating visual impairment may improve everyday cognitive functioning in some older people. This study aims to find out if the improvement in vision experienced after cataract surgery leads to improvement in memory and cognitive processing among older persons. The study will follow a group of adults aged 70 and older who are about ....It is possible that some of the confusion and memory loss experienced by older people is due to perceptual errors resulting from poor vision. If this is the case, then treating visual impairment may improve everyday cognitive functioning in some older people. This study aims to find out if the improvement in vision experienced after cataract surgery leads to improvement in memory and cognitive processing among older persons. The study will follow a group of adults aged 70 and older who are about to undergo cataract surgery and test them on measures of cognitive performance before surgery, and 3 and 12 months after surgery. Another group of older adults with cataracts who have not yet had surgery and a non-cataract group will also be studied over the 12 month period. The hypothesis of the study is that the group who have had cataract surgery will show greater improvement on the measures of memory and cognitive processing over the follow-up period than the other two groups. The design of the study will allow us to determine whether improvement is due to either; a) simply being able to see the tests better, b) improvement in mood and social participation as a result of cataract surgery; c) changes in the brain that occur from increased sensory stimulation; or d) a combination of these factors.Read moreRead less
Danger Ideation Reduction Therapy For Obsessive-Compulsive Checkers: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$156,447.00
Summary
Obsessive-compulsive disorder (OCD) is a psychiatric disorder that affects up to 3% of the general population. People with the disorder experience unpleasant intrusive thoughts that they find distressing and have a strong urge to perform particular behaviours. Fears about fire and burglary are common and excessive checking of electrical appliances and locks can take many hours a day. Checkers represent one of the largest OCD sub-groups. Because of the time-consuming nature of the condition, soci ....Obsessive-compulsive disorder (OCD) is a psychiatric disorder that affects up to 3% of the general population. People with the disorder experience unpleasant intrusive thoughts that they find distressing and have a strong urge to perform particular behaviours. Fears about fire and burglary are common and excessive checking of electrical appliances and locks can take many hours a day. Checkers represent one of the largest OCD sub-groups. Because of the time-consuming nature of the condition, social and occupational functioning is often severely restricted. Many sufferers will also experience extreme social isolation and depression. The World Health Organisation ranks this disorder as 20th among all causes of burden of disease. The development of effective interventions could substantially reduce the economic and social burden of this disabling anxiety disorder. The aim of this project is: (1) to compare the therapeutic efficacy of a new treatment approach (Danger Ideation Reduction Therapy) with that of Exposure and Response Prevention (ERP); It is hypothesised that: (1) subjects who receive 12 sessions of DIRT will show greater post-treatment and follow-up reductions in symptomatology than subjects who receive ERP.Read moreRead less
Randomised Controlled Trial Of A New Intervention For Alcohol Craving
Funder
National Health and Medical Research Council
Funding Amount
$780,673.00
Summary
Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and lo ....Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and long-term maintenance of change. Whilst current medications target craving, they provide only short-term symptom relief, and not all people find them effective. Cravings are both distracting and distressing during treatment, and increased craving often predicts treatment drop-out and relapse. This project evaluates a new treatment for alcohol misuse: CARM - Craving for Alcohol: Reduction and Management. This 8-session enhanced Cognitive-Behaviour Treatment (CBT) focuses on teaching people new skills to manage and reduce cravings, and is based on a new theory of craving that has strong research support. The study compares 4 groups: CARM; a more traditional CBT treatment for alcohol problems [motivational interviewing, problem solving for high-risk situations, and relapse prevention]; plus two brief interventions [Motivational Interviewing plus Self-Monitoring, and Self-Monitoring alone] both followed by CARM after an 8 week delay. All participants are able to set their own goals of abstinence or reduced use. Expected outcomes: all participants will learn effective skills to manage their alcohol use, resulting in significant reductions in alcohol consumption and fewer problems from alcohol use; however, those receiving CARM will find it easier to manage cravings during treatment, and will make faster progress and show less treatment drop-out. It is also anticipated that participants in CARM will show better long-term maintenance of treatment gains.Read moreRead less
Enhancing Treatment Effectiveness In Acute Stress Disorder
Funder
National Health and Medical Research Council
Funding Amount
$235,330.00
Summary
Posttraumatic stress disorder (PTSD) is the most common psychiatric condition to develop after trauma. Early intervention of PTSD following a trauma is indicated because chronic PTSD can be resistant to treatment. Early intervention is possible because acute stress disorder immediately after a trauma identifies those people who will develop chronic PTSD. Although cognitive behaviour therapy of acute stress disorder can effectively prevent PTSD in many cases, many people do not benefit from this ....Posttraumatic stress disorder (PTSD) is the most common psychiatric condition to develop after trauma. Early intervention of PTSD following a trauma is indicated because chronic PTSD can be resistant to treatment. Early intervention is possible because acute stress disorder immediately after a trauma identifies those people who will develop chronic PTSD. Although cognitive behaviour therapy of acute stress disorder can effectively prevent PTSD in many cases, many people do not benefit from this treatment because this treatment involves exposure to distressing memories and emotions, and this contributes to many people dropping out of treatment. This project aims to extend the utility of early intervention following trauma by assessing approaches that can be used by most trauma survivors. The project compares early intervention with either exposure, cognitive therapy, combined exposure and cognitive therapy, or supportive counseling. All therapy will be conducted in the initial four weeks and will comprise 6 sessions. Assessments will be conducted posttreatment, six-months follow-up, and one-year follow-up. The outcomes of this project will have significant public health benefits because they will lead to increased treatment effectiveness for acutely traumatized people, and will markedly reduce the incidence of PTSD in the community.Read moreRead less
It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible t ....It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible to further cognitive decline after anaesthesia and surgery. In order to explore the relationship between preoperative cognitive function and postoperative cognitive decline we plan to measure cognition in patients scheduled for elective hip replacement surgery. This is done by asking patients to complete a standard battery of cognitive tests. We will be then able to identify those patients who already have mild cognitive impairment before surgery and by repeated testing after the operation will be able to demonstrate if preoperative cognitive status is a determinant of postoperative cognitive dysfunction. The primary aim of the research is to test whether cognitive impairment before surgery leads to cognitive deficit after surgery in patients over the age of 65 undergoing total hip replacement surgery. The study will also establish the prevalence of pre-operative mild cognitive impairment and the magnitude of postoperative cognitive dysfunction after surgery in this patient group. The study will explore the relationship between preoperative cognitive status and postoperative cognitive deficit , providing information about the incidence, natural history and risk factors of postoperative cognitive deficit. This work will enable further research to isolate specific causative factors and identify therapeutic and prophylactic strategies.Read moreRead less
Which Treatment Works? New Approaches To Treating Emotion Perception Deficits After Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$500,937.00
Summary
Many people with traumatic brain injury (TBI) cannot recognise emotions in others. This makes appropriate social behaviour impossible and leads to isolation and unemployment. In this project we compare training that minimises errors (errorless learning) versus training that provides strategies for recognising emotions while allowing errors to occur. Adults with severe TBI will be allocated to one of the two treatments, a social non-therapeutic group or to deferred treatment (waitlist control).
Childhood Cognitive Antecedents Of Adult Psychopathology: Follow-up Of The Port Pirie Lead Cohort Into Adulthood
Funder
National Health and Medical Research Council
Funding Amount
$587,263.00
Summary
The role of childhood factors in the development of adult psychiatric disorder is an important public health concern. Indvividuals identified before birth and followed across the life course offer the most powerful means of establishing predictors for particular types of psychiatric disorder. Not only do these studies enable researchers to more clearly determine the exact age of onset of disorder but they also give us insight into the background and hence possible risk factors that may have lead ....The role of childhood factors in the development of adult psychiatric disorder is an important public health concern. Indvividuals identified before birth and followed across the life course offer the most powerful means of establishing predictors for particular types of psychiatric disorder. Not only do these studies enable researchers to more clearly determine the exact age of onset of disorder but they also give us insight into the background and hence possible risk factors that may have lead to the development of that disorder. Early identification of disorder can significantly reduce public health cost and reduce the burden on the community by enabling individuals to get help before their symptoms become too severe and unmanageable. Few long-term studies have investigated the combined role of pre-natal, developmental, parental characteristics, biological and childhood cognitive risk factors in the development of adult psychiatric dysfunction. Even fewer studies have examinined this interrelationship in a group of individuals who have been exposed to an environmental toxin such as lead. This study will follow-up 723 adults from the lead smelting city of Port Pirie who were originally recruited between 1979 and 1982. All adults were exposed to lead to some degree in childhood and have been followed over various time points over the course their lives. This project will be conducted 27 years since they were first involved, and will hence be one of the longest studies to be conducted in this field. The extensive information already collected on this group of individuals will enable us to create a very comprehensive picture of risk and protective factors for various types of adult disorder.Read moreRead less
Evaluation Of Internet-Based Treatments For Comorbidity Of Alcohol Disorders And Depressive Mood
Funder
National Health and Medical Research Council
Funding Amount
$710,333.00
Summary
Depression and alcohol problems often co-occur and contribute significantly to non-fatal disease burden in Australia. Psychological treatment for these illnesses is effective, but many Australians lack access to appropriate services. This study addresses this problem by offering treatment via the internet. This randomised controlled trial will compare three online treatments for comorbid alcohol use and depression.
Cardiac Intervention, Surgery And Cognitive Outcome (CISCO) Study
Funder
National Health and Medical Research Council
Funding Amount
$367,739.00
Summary
We propose to investigate the association between the presence of coronary artery disease and changes in brain function after therapeutic interventions. Patients undergoing surgery for coronary heart disease are prone to experience changes in mental function and higher level thought processes (cognition) after surgery, especially if they are elderly. As the population ages this is becoming a more significant problem. There is some limited evidence that this particular group of patients has a hig ....We propose to investigate the association between the presence of coronary artery disease and changes in brain function after therapeutic interventions. Patients undergoing surgery for coronary heart disease are prone to experience changes in mental function and higher level thought processes (cognition) after surgery, especially if they are elderly. As the population ages this is becoming a more significant problem. There is some limited evidence that this particular group of patients has a higher incidence of cognitive impairment than the normal population even before they present for surgery, because cardiovascular disease has also been shown to be associated with changes in cognition. To investigate this, we will measure cognitive status in patients over the age of 55 who have coronary artery disease and are being investigated with coronary angiography. This will provide an indication of the baseline cognitive status in patients presenting with coronary vascular disease. We will use validated neuropsychological tests that have been used to assess potsoperative cognitive decline. These tests are sufficiently sensitive to detect subtle changes in a number of areas of thought processing (cognitive domains) and thus identify those subjects who have cognitive impairment. Patients will then go on to be treated by surgery or angioplasty. We will continue to test these patients at time intervals for 3 months in order to track the changes in cognition in each treatment group. Thus we will be in the position to compare how these modalities of treatment for heart disease impact on patients mental function and cognition. In addition we will be able to tell whether a 'recovery' period might be of benefit following coronary angiography. If we are able to demonstrate different cognitive outcomes from different treatments and also an association with pre-existing cognition, this will guide clinical decision making to minimise harm to the brain.Read moreRead less