D-Cycloserine And Conditioning: Increasing The Effectiveness Of Exposure Therapy For Fear And Anxiety
Funder
National Health and Medical Research Council
Funding Amount
$400,750.00
Summary
The psychological, social, and financial costs of anxiety problems are among the highest burden-of-disease costs to the community. The most effective long-term psychological treatment for anxiety disorders is cognitive behaviour therapy (CBT), in particular exposure therapy. However only a small minority of individuals receive comprehensive treatment, and a portion of these individuals re-experience symptoms in the long-term. These difficulties are partially due to the cost of treatment and diff ....The psychological, social, and financial costs of anxiety problems are among the highest burden-of-disease costs to the community. The most effective long-term psychological treatment for anxiety disorders is cognitive behaviour therapy (CBT), in particular exposure therapy. However only a small minority of individuals receive comprehensive treatment, and a portion of these individuals re-experience symptoms in the long-term. These difficulties are partially due to the cost of treatment and difficulties with relapse. Recent research has shown that D-Cycloserine (DCS) facilitates extinction in animals and possibly in humans. DCS has the potential to offer a simple, brief, and cost-effective intervention that enhances treatment effects. In the United States the new NIMH director has set research into DCS and exposure to fear as a high priority that is likely to have a significant public health impact. This proposal provides an opportunity for Australian researchers to become involved in a rapidly expanding research field. The research team at UNSW have already established an international reputation in DCS applications, fear conditioning in humans, and clinical trials in humans. They are in a unique position internationally to investigate the means by which DCS exerts its effects and to conduct randomised clinical trials of DCS in recovery from fear in humans.The goal is to test DCS in facilitating exposure and extinction of fear. The research will directly lead to recommendations for clinical application and demonstrate whether the drug has the capability of significantly increasing the success of exposure therapy by reducing the time required for treatment, the rate of relapse, the financial cost of treatment, and the overall burden of anxiety to the community. The fear-conditioning studies will also inform our theoretical understanding of emotion processing and fear conditioning in humans, which in turn will allow clinical applications to be optimised.Read moreRead less
Neuroanatomical Dynamics Of Attention In Stroke Patients And Healthy Individuals: A Magnetic Stimulation Investigation
Funder
National Health and Medical Research Council
Funding Amount
$360,363.00
Summary
Mechanisms of selective attention are of central importance in guiding human behaviour. The brain uses attention to enhance the processing of information that is behaviourally relevant, and to suppress irrelevant information. The operation of attention within sensory modalities (vision, touch, hearing) has been studied for many decades; however, little is known about how attention combines information between different senses. An understanding of 'crossmodal' attention is important for many reas ....Mechanisms of selective attention are of central importance in guiding human behaviour. The brain uses attention to enhance the processing of information that is behaviourally relevant, and to suppress irrelevant information. The operation of attention within sensory modalities (vision, touch, hearing) has been studied for many decades; however, little is known about how attention combines information between different senses. An understanding of 'crossmodal' attention is important for many reasons. First, real events in the environment provide inputs simultaneously from different locations to multiple senses, and these inputs must be integrated to yield coherent perception. Second, the most basic aspects of human perception depend upon attention; the brain implements selective mechanisms in order to filter the immense quantities of information that constantly bombard our sensory receptors. Finally, many neurological disorders are characterised by impairments of attention; these syndromes are debilitating for the patients themselves, and also place a heavy burden on caregivers and the healthcare system. This project will examine mechanisms of attention in healthy individuals and in stroke patients with attentional deficits. In all experiments, we will employ a new technique in neuroscience called 'transcranial magnetic stimulation' (TMS). TMS enables the safe and reversible stimulation of brain activity in humans. In the current project, we will use TMS with two broad objectives: (i) to determine the key brain areas involved in crossmodal attention in healthy individuals, and (ii) to treat attentional deficits that occur within and between the senses in stroke patients ('magnetic stimulation rehabilitation'). This research will provide important insights into the brain mechanisms that govern selective attention in the healthy brain, and will help guide future methods for managing and treating neurological disorders in which deficits of attention are prominent.Read moreRead less
Crossmodal Interactions In Selective Attention: A Combined Human Lesion/transcranial Magnetic Stimulation Study
Funder
National Health and Medical Research Council
Funding Amount
$188,182.00
Summary
Aspects of attention are of central importance in guiding human behaviour. The brain uses these mechanisms to enhance the processing of sensory information that is currently relevant for behaviour, and to suppress irrelevant sensory information. Although there is a considerable body of knowledge, from both animal and human research, on how attention operates within individual sensory modalities (vision, touch, hearing, etc.), very little is known about how attention integrates information across ....Aspects of attention are of central importance in guiding human behaviour. The brain uses these mechanisms to enhance the processing of sensory information that is currently relevant for behaviour, and to suppress irrelevant sensory information. Although there is a considerable body of knowledge, from both animal and human research, on how attention operates within individual sensory modalities (vision, touch, hearing, etc.), very little is known about how attention integrates information across these different modalities. An understanding of these 'crossmodal' attentional mechanisms is important for several reasons. First, much brain activity in primary sensory areas is modulated by the attentive state of the individual, so discovering how crossmodal attention works will facilitate our understanding of the neural mechanisms of sensory processing generally. Second, the most basic aspects of human perception are fundamentally dependent upon attention; without attention we would perceive inputs from the different senses as fragmentary, rather than as bound together into coherent multimodal representations. Finally, many acquired and developmental neurological disorders are characterised by debilitating impairments of attention. This project will examine crossmodal spatial attention in stroke patients with damage to an exclusively visual brain area (occipital cortex), or to a multisensory brain area (parietal cortex). It will also measure the extent of crossmodal interactions in healthy participants, using cortical transcranial magnetic stimulation (TMS) to induce reversible, 'virtual' lesions that mimic those of the stroke patients. The specific goals of the research are to explain how inputs from the senses of vision and touch interact to give rise to coherent perception; and to provide an empirical foundation for the development of more effective rehabilitative techniques for stroke patients, by exploiting any preserved crossmodal attentional mechanisms.Read moreRead less
Drinking Patterns, Gender And Social Roles In Alcohol Problems In Victoria, In An International Comparative Context
Funder
National Health and Medical Research Council
Funding Amount
$342,239.00
Summary
The varied impacts of drinking in the family and other gendered relations are an important and understudied aspect of alcohol studies, with general social and policy implications. The proposed research will make an important contribution to developing quantitative research in this area in Australia. The project uses concepts and measures which are novel in an Australian environment, and the international comparative aspect of the project, with comparable questionnaires in a wide diversity of soc ....The varied impacts of drinking in the family and other gendered relations are an important and understudied aspect of alcohol studies, with general social and policy implications. The proposed research will make an important contribution to developing quantitative research in this area in Australia. The project uses concepts and measures which are novel in an Australian environment, and the international comparative aspect of the project, with comparable questionnaires in a wide diversity of societies, is novel and innovative for the alcohol research field in general. Measures of social problems from drinking, and particularly and family and relationship, developed in analysing the study material will be made more broadly available for use in future studies, raising the possibility that the study may serve as a first measurement point for future data-series over time.Read moreRead less
Effects Of Lead And Socio-cultural Factors On Cognition And Behaviour Of Children In Port Pirie And Broken Hill
Funder
National Health and Medical Research Council
Funding Amount
$394,825.00
Summary
The effect of lead on children's 'intelligence' is controversial. Poorer IQ scores in children with higher exposure to lead, have been found reasonably consistently, - but there is disagreement on whether lead exposure is simply a common ASSOCIATE of poor IQ, or whether it actually CAUSES deficits. In 1994, the NHMRC prudently recommended a graded series of interventions to be implemented, depending on the proprtion of children in the community with blood lead concentrations in specific categori ....The effect of lead on children's 'intelligence' is controversial. Poorer IQ scores in children with higher exposure to lead, have been found reasonably consistently, - but there is disagreement on whether lead exposure is simply a common ASSOCIATE of poor IQ, or whether it actually CAUSES deficits. In 1994, the NHMRC prudently recommended a graded series of interventions to be implemented, depending on the proprtion of children in the community with blood lead concentrations in specific categories above 10 ug lead -100 ml of blood. The choice of this figure (10 ug-dl) was more pragmatic than scientific; there being very little data on the health effects of exposures below 10 ug-dl available at that time. A recent analysis of pooled data from past studies has now suggested there may be very large effects on child IQ at blood lead concentration BELOW 10 ug-dl. Health authorities will soon be lobbied intensely to spend vast sums on new lead abatement programs. Cities like Port Pirie and Broken Hill (where cooperative programs have achieved such significant reductions in lead exposure that a high percentage of their children now have blood lead levels below 10 ug-dl), will be forced to examine expensive options to avoid closure of the industries which provide their economic backbones, if this analysis proves to be correct. Our proposal argues that before committing to new and costly abatement programs, there is an urgent need to augment our evidence-base by conducting a new study ofchildren with lead exposures below 10 ug-dl, using more modern measures of intelligence. The study will pay closer attention to some of the socio-cultural and inherited determinants of child IQ which may have confounded the lead-IQ association in past studies, and will supplement IQ assessments (which are now considered to derive from a very old and narrow view of intelligence) with new tools for measuring 'intelligence' that may be less socio-culturally dependent.Read moreRead less
Living In A Rural Community: A Longitudinal Study Of The Course And Outcome Of Mental Health And Wellbeing.
Funder
National Health and Medical Research Council
Funding Amount
$841,947.00
Summary
This unique rural Australian study will investigate individual, family and community factors associated with the mental health and wellbeing of residents in rural communities of New South Wales. It aims to identify factors that may maintain or promote mental health, thereby investigating the potential protective effect of community factors, as well as more proximal social factors (such as family-household attributes and responses) on dimensions of mental health and wellbeing among rural people.
Changing Heat: Direct Impacts Of Temperature On Health And Productivity - Current Risks And Climate Change Projections
Funder
National Health and Medical Research Council
Funding Amount
$277,915.00
Summary
We know that heatwaves kill people - some 50,000 died in the 2003 European heatwave - but little is known of the details. This project will discover those details, in three important dimensions: WHO is at risk, and where do they live; HOW are people at risk, e.g. from kidney failure; and just WHAT is it about heat that is most dangerous? We will then build mathematical models of the future risks, and explore what public health measures will best protect Australians in a warming climate.
Cross-Sectional And Longitudinal Evaluation Of Childhood Anxiety And Depression: Pathways, Risk Factors And Prevention
Funder
National Health and Medical Research Council
Funding Amount
$333,055.00
Summary
Anxiety and depression are the most common forms of psychological distress affecting Australian children today. These disorders are seriously disabling and continuous across time. Therefore, it is very important to understand more about the onset and course of these disorders, and about factors which influence these disorders in either a positive or negative manner. There are three major goals for the current project. The first is to further our understanding of the development, maintenance, and ....Anxiety and depression are the most common forms of psychological distress affecting Australian children today. These disorders are seriously disabling and continuous across time. Therefore, it is very important to understand more about the onset and course of these disorders, and about factors which influence these disorders in either a positive or negative manner. There are three major goals for the current project. The first is to further our understanding of the development, maintenance, and amelioration of anxiety and depression in a child and youth population. The second is to understand the relationship between these two disorders in children and youth. The third is to use the acquired information to assist in the identification of optimal ages for preventive interventions, and to aid in the matching of interventions to the specific needs and vulnerabilities of children versus adolescents. This project aims to meet these goals through implementation of a controlled prevention trial. The aims fo the research are: 1. To examine the relationship between symptoms of anxiety and depresison in Australian children and youth 2. To gain valuable clinical information regarding the assessment and prevention of these disorders 3. To understand the risk and protective factors associated with these disorders, and the impact of these factors over time 4. To implement and evaluate a school-based prevention program The expected outcomes of the research are: 1. To acquire valuable information related to the onset and course of anxiety and depression in children and youth, and their associated risk and protective factors 2. To further development of more timely and targeted interventions for the prevention of anxiety and depression 4. To enhance the emotional resilience of participating children and prevent the onset of anxiety and depression 5. To promote Australian research by publishing the results of the project within the international research literatureRead moreRead less
Living In A Rural Community:determinants And Consequences Of Mental Health And Wellbeing.
Funder
National Health and Medical Research Council
Funding Amount
$729,415.00
Summary
Th e proposed study will investigate individual, family and community factors associated with the mental health and wellbeing of residents in rural communties of NSW. It will also examine rural residents' perceptions of their mental health needs and their access and utilisation of health services. The study will be conducted in 3 rural Area Health Services in NSW (Greater Western,Hunter New England and North Coast) comprising 70% of the rural population of NSW. These health regions encompass rur ....Th e proposed study will investigate individual, family and community factors associated with the mental health and wellbeing of residents in rural communties of NSW. It will also examine rural residents' perceptions of their mental health needs and their access and utilisation of health services. The study will be conducted in 3 rural Area Health Services in NSW (Greater Western,Hunter New England and North Coast) comprising 70% of the rural population of NSW. These health regions encompass rural, remote and coastal NSW. We aim to conduct the mail and telephone survey on adults residing in 4000 households across the 3 regions. Unique aspects of the study include: i) Examination of a diverse range of rural communities which will provide the opportunity to investigate the influence and interaction of specific community characteristics on mental health. These community factors will include social and economic factors, severity of rural environmental stress (eg drought), and the levels of access to health and other services. ii) Focus on the household and its members so as to examine the mental health needs of family groups in rural communities. This cross-sectional study will form the baseline for a longitudinal study investigating the changes experienced by rural families over time and the impact of such change on mental health outcomes.Read moreRead less