Adult Consequences Of Childhood Exposure To Psychological Trauma
Funder
National Health and Medical Research Council
Funding Amount
$292,530.00
Summary
The importance of childhood experience to adult adjustment (DOES THIS MAKE SENSE) is an issue of general public health interest. In particular, in the area of personality development, there are a number of theories concerning the importance of childhood experience and developmental stresses on later personality, development, psychological functioning and physical health. More recently there has been debate on the accuracy with which adults areable to remember traumatic experiences in childhood. ....The importance of childhood experience to adult adjustment (DOES THIS MAKE SENSE) is an issue of general public health interest. In particular, in the area of personality development, there are a number of theories concerning the importance of childhood experience and developmental stresses on later personality, development, psychological functioning and physical health. More recently there has been debate on the accuracy with which adults areable to remember traumatic experiences in childhood. This study will follow a group of 808 primary school children who were exposed to the 1983 Ash Wednesday bushfires in SOuth Australia. They were involved in a study which examined them two months, eight months and twenty six months after the disaster. This rich descriptive set of information about these children and their families forms an objective data base against which their adult recall of the experience can be judged. The symptoms of these children were also documented at the time as was their disaster exposure. The impact of this one event, in the context of the other developmental influences will be examined as determinants of their adjustment in adult life. Finally, there has been an increasing interest in the way that previous traumatic exposure influences the nature of the hormonal response to stress. Using a test of functioning of the cortisol system, the stress response of this population will be compared with a control population who were also studied at the time of the original disaster.Read moreRead less
Acceptance And Commitment Therapy For Medication-resistant Psychosis: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$558,200.00
Summary
In spite of advances in medication, approximately one third of people with schizophrenia continue to experience distressing symptoms such as hearing voices and paranoia. Psychological 'talking treatments' are effective in helping people to cope with and be less distressed by these experiences. This study will be the first trial of a new psychological treatment, called Acceptance and Commitment Therapy, which may be more effective, briefer and more easily provided than existing approaches.
Efficacy Of Treatment For Resistant Command Hallucinations.
Funder
National Health and Medical Research Council
Funding Amount
$343,875.00
Summary
Auditory hallucinations (AHs), often described as voices, are a common symptom of schizophrenia and psychoses. Command hallucinations (CHs) are a type of AH in which the voice heard by the patient commands him or her to perform a particular action. The nature of the directive may vary from inconsequential actions to commands to harm the patient or others. There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the communit ....Auditory hallucinations (AHs), often described as voices, are a common symptom of schizophrenia and psychoses. Command hallucinations (CHs) are a type of AH in which the voice heard by the patient commands him or her to perform a particular action. The nature of the directive may vary from inconsequential actions to commands to harm the patient or others. There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. There is firm evidence pointing to the important role that CHs play in propelling psychotic individuals into serious and damaging actions. We have found, however, that most individuals who comply with dangerous CHs do so, not because they are angry, violent, antisocial or wish to cause harm, but because they feel powerless to resist. Though CHs are one of the most disturbing symptoms of psychosis, standard treatment has proved to be of limited benefit. This study will evaluate the effectiveness of Treatment of Resistant Command Hallucinations (TORCH), an innovative treatment for CHs. TORCH is an extension of an existing treatment for psychosis that we previously developed. TORCH aims to reduce the distress, worry and harmful or self-defeating behaviour associated with CHs by arming the patient with effective strategies that will enhance resistance and reduce compliance. The project has clear implications for improved clinical and therapeutic management of CHs with major public health, clinical and forensic repercussions. The consequences of being formally assessed as being at risk of acting violently result in the potential for substantial restrictions on the freedom of the individual. The availability of TORCH may prompt a less restrictive management of individuals at risk of dangerous behaviour and promote a more optimistic attitude amongst clinicians. Relatives and carers also stand to benefit through reduction in perplexing and fear-inducing behaviours.Read moreRead less
Modelling The Characteristics And Symptoms In First-episode Psychosis From Baseline To Long-term Follow-up
Funder
National Health and Medical Research Council
Funding Amount
$22,257.00
Summary
Relatively little is known about the progression of first-episode psychosis over the longer term. This research will investigate the course and evolution of psychiatric symptoms in over 600 psychotic patients up to 10 years following initial admission. It may be possible to identify groupings of patients with similar patterns of change in symptoms, along with factors underlying different patterns of symptom course, which may help distinguish the fundamental mechanisms underlying psychosis.
An Investigation Of The Aetiology Of Eating Disorders: Interactions Between Genes And Environmental Risk Factors.
Funder
National Health and Medical Research Council
Funding Amount
$225,000.00
Summary
Eating disorders, along with substance abuse, carry the highest risk of premature death, from both natural and unnatural causes, out of 27 mental disorder categories. Eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder, affect about 6% of Australian women. Despite increased levels of research into the aetiology of eating disorders over the last 20 years, little knowledge exists as to which risk factors cause women to attempt weight loss to the point of increa ....Eating disorders, along with substance abuse, carry the highest risk of premature death, from both natural and unnatural causes, out of 27 mental disorder categories. Eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder, affect about 6% of Australian women. Despite increased levels of research into the aetiology of eating disorders over the last 20 years, little knowledge exists as to which risk factors cause women to attempt weight loss to the point of increasing their risk of premature mortality. A review of twin studies in eating disorders concludes that there is increasing evidence to suggest that genetic factors play a role in the development of eating disorders. In addition, a recent series of studies, examining risk factors before the age of eating disorder onset, have found the following events to specifically predict the development of an eating disorder as opposed to another psychiatric condition: negative self-evaluation, parental alcoholism, low parental contact and high parental expectations, critical comments about weight, shape or eating during childhood, and childhood obesity. To date, no studies have attempted to integrate the findings from twin studies with the findings from early risk factor studies. Specifically, the ways in which genes interact with the environment to increase the chances of genetic vulnerability to an eating disorder being expressed have not been examined. The proposed project seeks to investigate precisely these interactions between genes and the environment, by examining a large number of female twins, aged 29-37. An enhanced understanding of how genes interact with the environment to either increase the chances that a woman will develop an eating disorder, or alternatively to protect a woman from developing an eating disorder, will benefit our understanding of how to target prevention and treatment strategies.Read moreRead less
Depression And Risk Of Coronary Heart Disease: A Prospective Study Of Mediating Haemostatic Risk Factors
Funder
National Health and Medical Research Council
Funding Amount
$327,625.00
Summary
Growing evidence suggests that depression, anger and anxiety play a role in causing coronary heart disease (CHD) and complicating the outcome in existing CHD. This may occur by effects of these emotions on promoting blood clotting and the stickiness of platelets - the blood cells responsible for blood clotting. This pilot study will follow a group of people with depression but without CHD and a control group over 8 months to compare how the blood clotting profile changes as depression resolves. ....Growing evidence suggests that depression, anger and anxiety play a role in causing coronary heart disease (CHD) and complicating the outcome in existing CHD. This may occur by effects of these emotions on promoting blood clotting and the stickiness of platelets - the blood cells responsible for blood clotting. This pilot study will follow a group of people with depression but without CHD and a control group over 8 months to compare how the blood clotting profile changes as depression resolves. The potential benefits of this research are a better understanding of the links between the common illnesses of depression and CHD that might improve the prevention and treatment of heart disease.Read moreRead less
Psychiatric Morbidity, Quality Of Life And Coping Styles Of Patients With Early Stage & Advanced Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$281,018.00
Summary
Prostate cancer affects thousands of men each year. Advances in treatment are continuing, but side-effects frequently create disruptions to daily living. If the quality of care for prostate cancer patients is to be further improved, there is much to be learned about the psychosocial impact of the disease and its treatment across its different phases. There has not been a systematic prospective study of psychosocial adjustment in men with prostate cancer. In this study, we longitudinally follow t ....Prostate cancer affects thousands of men each year. Advances in treatment are continuing, but side-effects frequently create disruptions to daily living. If the quality of care for prostate cancer patients is to be further improved, there is much to be learned about the psychosocial impact of the disease and its treatment across its different phases. There has not been a systematic prospective study of psychosocial adjustment in men with prostate cancer. In this study, we longitudinally follow two separate groups of men with prostate cancer, those with early disease and those with advanced illness. We focus on the particular side-effects of urinary incontinence, impotence and bowel symptoms and the potential these have to affect the patient's sense of wellbeing. We use a standardised interview and questionnaires to assess for the presence of psychiatric disorders and psychological problems, overall quality of life and coping styles in these men. We seek to recognise the predictors of men who may have coping problems. A statistical approach termed pathway analysis will help us understand the relative contributions of different factors associated with these problems. The outcome of this systematic, longitudinal study will be a body of knowledge concerning risk factors for poorer psychosocial adjustment and optimum coping strategies for managing the impact of prostate cancer and its treatment, thereby empowering a range of targeted interventions to be developed to enhance the wellbeing and quality of life of these men.Read moreRead less
The Role Of Stress, HPA-axis Dysfunction And CNS Structural And Functional Change In The Development Of Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$345,538.00
Summary
This research will further understanding of the processes underlying the development of serious mental illnesses such as schizophrenia and may lead to the development of strategies to prevent these devastating disorders. Although there have been advances in the management of psychotic disorders in recent years, their underlying causes remain largely unknown. We aim to investigate the potential roles of stress, HPA-axis function and structural and functional brain changes. The neurodevelopmental ....This research will further understanding of the processes underlying the development of serious mental illnesses such as schizophrenia and may lead to the development of strategies to prevent these devastating disorders. Although there have been advances in the management of psychotic disorders in recent years, their underlying causes remain largely unknown. We aim to investigate the potential roles of stress, HPA-axis function and structural and functional brain changes. The neurodevelopmental model of psychosis suggests that small structural CNS changes occur very early in life conferring a degree of vulnerability on the affected individual. We propose that the psychological and neurobiological processes listed above interact with the pre-existing vulnerability, resulting in the development of psychotic symptoms. This is in line with the stress-vulnerability model of psychosis. We aim to investigate this model by monitoring the level of stress reported by young people at risk of psychosis over 12 months. We will also obtain measures of their biological response to stress by assessing cortisol levels over time and brain structure and functioning will be assessed. By monitoring these processes in the high risk group, we will be able to identify any changes that occur if a psychotic illness develops. This research also has practical applications in the identification of young people at high risk of developing a psychotic disorder, Moreover it will inform the development of medical and psychological strategies aimed at preventing or delaying the onset of schizoprenia and related illnesses in the high risk population.Read moreRead less
Relationship Between Anterior Cingulate Morphology, Neuronal Integrity And Function In Schizophrenia And OCD
Funder
National Health and Medical Research Council
Funding Amount
$312,813.00
Summary
Schizophrenia and obsessive-compulsive disorder (OCD) are extremely disabling psychiatric disorders. Both tend to appear in early adulthood and have a number of important similarities. These include problems with planning and organising thoughts, abnormal brain chemistry, and changed function in the same brain region, the anterior cingulate. The anterior cingulate has been known for some time to be involved in emotion, motivation and attention. However, it is now recognised as the interface betw ....Schizophrenia and obsessive-compulsive disorder (OCD) are extremely disabling psychiatric disorders. Both tend to appear in early adulthood and have a number of important similarities. These include problems with planning and organising thoughts, abnormal brain chemistry, and changed function in the same brain region, the anterior cingulate. The anterior cingulate has been known for some time to be involved in emotion, motivation and attention. However, it is now recognised as the interface between the emotional, feeling part of the brain and the controlling, thinking part. Many, if not all, of the functions performed by the anterior cingulate are disturbed in both schizophrenia and OCD, meaning that studying this region may provide important clues to the nature of the two illnesses. One important characteristic of the anterior cingulate which has not been considered in previous research is its division into three distinct subregions, each with their own specific function. In particular, there is a cognitive region, which deals with response selection and information processing, and an emotional region, which assesses motivational content and controls emotional learning. Because of the nature of the two disorders we intend to study, we believe that schizophrenia will be associated with more abnormalities of the cognitive region, while OCD will be associated with changes in the emotional region. Another important feature of our research design is that we intend to collect data from the same subjects using four separate brain imaging techniques, which provide information about different levels of brain structure and function. This will allow us to interpret our findings from measures of brain chemistry in the context of our findings of brain function. Hopefully this will help us to clarify the pathophysiology of schizophrenia and OCD, and provide potential ways to assess the effect of different treatment strategies in these illnesses.Read moreRead less
Diabetes And Dementia: Studies With The Fremantle Diabetes Study Cohort.
Funder
National Health and Medical Research Council
Funding Amount
$315,509.00
Summary
Dementia is an extremely serious condition which affects a large proportion of the older population. Recent evidence has shown that diabetes, which is another common condition in the elderly, doubles the risk of an older person developing Alzheimer's disease and other forms of dementia. Why this happens is unknown but insulin therapy has been highlighted as a possible cause. As many older people are on insulin for their diabetes, it is extremely important to confirm or refute this finding. It se ....Dementia is an extremely serious condition which affects a large proportion of the older population. Recent evidence has shown that diabetes, which is another common condition in the elderly, doubles the risk of an older person developing Alzheimer's disease and other forms of dementia. Why this happens is unknown but insulin therapy has been highlighted as a possible cause. As many older people are on insulin for their diabetes, it is extremely important to confirm or refute this finding. It seems possible that insulin may not be the direct cause but that some other associated factor such as poor diabetes control, recurrent hypoglycaemic attacks or cerebrovascular disease causes dementia. On theoretical grounds, Alzheimer's disease may have a vascular basis. If Alzheimer's disease was, in part, caused by vascular disease then there is the potential to prevent cases of dementia developing by paying attention to the known risk factors for vascular disease such as hypertension. The Fremantle Diabetes Study is an ideal group of community living diabetic individuals in which we can study whether some or all of these factors cause Alzheimer's disease or dementia and gain insights into the potential for prevention.Read moreRead less