Journal of Policy and Practice in Intellectual Disabilities, 2018
A number of practice guidelines are available to set the benchmark for best practice when working... more A number of practice guidelines are available to set the benchmark for best practice when working with individuals with intellectual disabilities and co‐morbid mental health concerns. However, dissemination and implementation of such guidelines in the context of psychologists' work settings has received little attention. The aim of this qualitative study was to investigate adherence to current practice guidelines by Australian psychologists working with this specialist population and explore organizational factors that may facilitate or hinder evidence‐based practice implementation. Thirty‐eight Australian psychologists from government disability and non‐government disability organizations working primarily with individuals with intellectual disability participated in eight semistructured focus groups. Psychologists were presented with a summary of a current Australian practice guideline in dual disabilities and asked about their views of best practice adherence and implementation of the guideline including facilitative and hindering factors influencing implementation. Psychologists reported views consistent with current Australian best practice standards but noted a number of barriers impacting on adherence. Facilitators and hindrances to best practice implementation were discussed in relation to views on applicability of current guideline, organizational level considerations, organizational resources and training, organizational operations, and systemic considerations. Findings highlight the importance of a collaborative and systemic approach in order for practice guidelines to be effectively implemented for psychologists working with disabilities. Implications for policy development and training are discussed.
Working with individuals with dual disabilities can be a complex process in the presence of limit... more Working with individuals with dual disabilities can be a complex process in the presence of limited evidence base to guide clinical practice. The aims of this qualitative study were to investigate perceptions of best practices of Australian psychologists who work with this specialist population. Thirty-eight Australian psychologists working in the intellectual disability field participated in eight semistructured focus groups. Perceptions of evidence-based practice for individuals with intellectual disabilities and in relation to mental health assessment were explored. Psychologists demonstrated resourcefulness in adapting to limits in available evidence-based practice and in modifying mainstream practice to suit the needs of individuals with dual disabilities. Findings suggest the necessity of practice-based evidence in contributing to the evidence base, and person-centered approaches in relation to best practice for people with intellectual disabilities. Implications for strengthening psychologists’ clinical competency and bridging the research and practice gap are discussed.
The aim of this study was to examine carer experiences with mental health services for individual... more The aim of this study was to examine carer experiences with mental health services for individuals with dual disabilities in Australia. This qualitative study involved semi-structured interviews with nine parents with an adult offspring with an intellectual disability in 2016. Parents who had received a mental health service for their offspring within the past two years in Australia with adequate spoken English were included. Parents were asked four open ended questions relating to their experiences of mental health services for their offspring. Findings revealed parents reported more negative experiences with mental health services perceived to hold limited expertise in dual disabilities. They also reported difficulties in accessing appropriate services and highlighted the importance of collaboration and adjustments to suit individual needs of their child. The findings are discussed in terms of the implications for service provision and training for practitioners working with families with intellectual disabilities. Acknowledging the important role of carers as key informants and partners in treatment decision making is highlighted as necessary aligning services with best practice standards.
Research has indicated that adults diagnosed with a primary brain tumor (BT) are susceptible to e... more Research has indicated that adults diagnosed with a primary brain tumor (BT) are susceptible to experiencing anxiety and depressive problems post-diagnosis. However, there is a notable paucity of psychological interventions which have been tested with adult BT patients. An acceptance and commitment therapy (ACT)-based manualized program was developed for anxious and/or depressed BT patients. The preliminary efficacy of this program was initially tested using a proof-of-concept study design based on a case series of four clinically distressed BT patients. Three of the four participants no longer met criteria for anxiety and/or depressive disorders at post-therapy, and these effects were maintained at 3 months of follow-up. The fourth participant, who had a premorbid psychiatric history, experienced a stabilization of anxiety and depressive symptoms. Given the current dearth of studies which have tested psychological interventions for distressed BT survivors, these preliminary findings have promising clinical utility. However, the efficacy of psychological interventions tailored for clinically distressed BT patients needs to be further tested using larger-scale controlled trial designs.
The present study was designed to examine the effects of training in positive interpretations in ... more The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of 87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.
Background: Adult brain tumor (BT) patients and longer-term survivors are susceptible to experien... more Background: Adult brain tumor (BT) patients and longer-term survivors are susceptible to experiencing emotional problems, including anxiety and/or depression disorders, which may further compromise their quality-of-life (QOL) and general well-being. The objective of this paper is to review sychological approaches for managing anxiety and depressive symptoms in adult BT patients. A review of psychological interventions comprising mixed samples of oncology patients, and which included BT patients is also evaluated. The review concludes with an overview of a recently developed transdiagnostic psychotherapy program, which was specifically designed to treat anxiety and/or depressive symptoms in adult BT patients. Methods: Electronic databases (PsycINFO, Medline, Embase, and Cochrane) were searched to identify published studies investigating psychological interventions for managing anxiety and depressive symptoms in adult BT patients. Only four randomized controlled trials (RCTs) were identified. Results: Only one of the RCTs tested a psychosocial intervention, which was specifically developed for primary BT patients, and which was found to improve QOL including existential well-being as well as reducing depressive symptoms. A second study tested a combined cognitive rehabilitation and problem-solving intervention, although was not found to significantly improve mood or QOL. The remaining two studies tested multidisciplinary psychosocial interventions in heterogeneous samples of cancer patients (included BT patients) with advanced stage disease. Maintenance of QOL was found in both studies, although no secondary gains were found for improvements in mood. Conclusion: There is a notable paucity of psychological interventions for adult BT patients across the illness trajectory. Further research is required to strengthen the evidence base for psychological interventions in managing anxiety and depressive symptoms, and enhancing the QOL of distressed adults diagnosed with a BT.
Australian Journal of Psychology, in press (doi: 10.1111/ajpy.12097)
Objective: Research suggests that the way anger is expressed and efforts to control anger may be ... more Objective: Research suggests that the way anger is expressed and efforts to control anger may be particularly important in post-traumatic stress disorder (PTSD). However, factors influencing the association between PTSD symptom severity and anger expression and control, and whether these associations are influenced in part by cognitive processes, have yet to be investigated
in combat veterans. The aim of the present study was to investigate the mediating effect of trauma-related cognitive variables between combat-PTSD symptom severity and anger expression in Australian veterans. Method: A sample of 149 treatmentseeking Australian older-aged veterans with chronic combat-related PTSD completed a battery of measures that assessed combat-PTSD symptom severity, anger indices, trauma-related rumination, cognitive suppression, and trauma appraisals.
Results: Path analyses revealed that negative beliefs about self partially mediated the effect of PTSD symptom severity and anger suppression, and PTSD symptom severity and anger control, while negative beliefs about the world partially mediated the association between PTSD severity and outward expression of anger. A significant direct effect from combat-PTSD symptom severity to outward expression was also found. Conclusions: Findings lend support to targeted assessment and treatment of
negative trauma-related appraisals, particularly negative beliefs about self and the world, to concomitantly enhance anger coping and emotion regulation in middle- to older-aged veterans with chronic combat-related PTSD.
Objective: The aim of the current study was to compare the effects of instructed cognitive reappr... more Objective: The aim of the current study was to compare the effects of instructed cognitive reappraisal, acceptance and emotional suppression on state anger after provocation among individuals with high trait anger. The moderating effects of trait
emotion regulation (ER) styles were also examined. Method: Adults (N=102) with elevated levels of trait anger were randomised to one of three ER conditions. Participants
in both the reappraisal and emotional suppression conditions reported a decline in state anger and systolic blood pressure (SBP) post-anger provocation, whereas participants in the acceptance group did not experience a substantial decline
in state anger or SBP post-anger provocation. Trait suppression was further found to enhance the effects of instructed suppression, while trait tolerance augmented the effects of instructed reappraisal. Conclusions: Support was found for the
use of reappraisal and emotional suppression as adaptive strategies to cope with anger arousal in the short term after provocation.
Cognitive and Behavioral Practice; (In press, 2014); doi: 10.1016/j.cbpra.2014.05.002
Depression and anxiety disorders, including PTSD, are highly prevalent and frequently co-occur in... more Depression and anxiety disorders, including PTSD, are highly prevalent and frequently co-occur in newly diagnosed head and neck cancer (HNC) patients, as well as in longer-term survivors. There is, however, scant empirical
evidence to inform clinicians how to best treat distressed HNC patients, particularly in the initial months following their diagnosis. The present article describes the development of a brief, early cognitive-behavioral intervention (the HNCCBT
program) in treating cancer-related PTSD and/or comorbid anxiety and depressive disorders in recently diagnosed HNC patients. The program was developed to be implemented concurrently with patients’ medical treatment(s) to help
individuals manage their acute anxiety and PTSD reactions, as well as prevent chronic psychopathology in the postmedical treatment recovery phase. A case study is also presented to illustrate how to apply this intervention with
clinically distressed HNC patients. Feasibility issues are also discussed in the implementation of this program during the course of medical treatment.
Stress and Health; (in press, 2014); DOI: 10.1002/smi.2567
The aim of the present study was to investigate whether reduced autobiographical memory and futur... more The aim of the present study was to investigate whether reduced autobiographical memory and future event
specificity were associated with elevated depressive and stress symptoms immediately and 1 week following exposure
to a trauma film. A non-clinical sample comprising 101 participants completed all phases of the study, which
included the following: baseline tests of autobiographical memory and future event specificity; a diary recording
intrusions of the film over a 7-day period; and self-report questionnaires assessing depressive, posttraumatic stress
and ruminative symptoms 7 days following the trauma film viewing. Overgeneral autobiographical memory was
significantly related to deficits in the specificity with which participants imagined future events. Participants who
were more specific when remembering past and imagining future events reported less intrusions related to the
trauma film over the 7-day period following the film; however, event specificity was not associated with depressive
and stress symptoms 7 days later. These findings suggest that reduced past and future event specificity may play a
role in the experience of intrusions following the experience of a stressful event.
Frontiers in Psychiatry; 2013; Open Access; http://www.frontiersin.org/affective_disorders_and_psychosomatic_research/10.3389/fpsyt.2013.00122/full
Australian Journal of Psychology, in press, doi: 10.1111/ajpy.12027, 2013
The objective of the current study was to investigate whether emotion pictorial cues increase mem... more The objective of the current study was to investigate whether emotion pictorial cues increase memory specificity among non-clinical participants. Undergraduate university students were presented with emotion word and pictorial cues on a prompted and nonprompted version of the Autobiographical Memory Test (AMT). In comparison to pictorial cues, participants retrieved significantly fewer specific autobiographical memories in response to word cues on the prompted AMT; however, there was no significant difference on the non-prompted AMT. Participants also retrieved significantly fewer specific memories in response to both word and pictorial cues on the non-prompted AMT compared with the prompted AMT. These results provide support for the hypothesis that among non-clinical participants, visual cues increase memory specificity over and above emotion. Further research is needed to investigate ways in which memory specificity can be increased and the use of imagery may be a promising avenue.
Journal of Policy and Practice in Intellectual Disabilities, 2018
A number of practice guidelines are available to set the benchmark for best practice when working... more A number of practice guidelines are available to set the benchmark for best practice when working with individuals with intellectual disabilities and co‐morbid mental health concerns. However, dissemination and implementation of such guidelines in the context of psychologists' work settings has received little attention. The aim of this qualitative study was to investigate adherence to current practice guidelines by Australian psychologists working with this specialist population and explore organizational factors that may facilitate or hinder evidence‐based practice implementation. Thirty‐eight Australian psychologists from government disability and non‐government disability organizations working primarily with individuals with intellectual disability participated in eight semistructured focus groups. Psychologists were presented with a summary of a current Australian practice guideline in dual disabilities and asked about their views of best practice adherence and implementation of the guideline including facilitative and hindering factors influencing implementation. Psychologists reported views consistent with current Australian best practice standards but noted a number of barriers impacting on adherence. Facilitators and hindrances to best practice implementation were discussed in relation to views on applicability of current guideline, organizational level considerations, organizational resources and training, organizational operations, and systemic considerations. Findings highlight the importance of a collaborative and systemic approach in order for practice guidelines to be effectively implemented for psychologists working with disabilities. Implications for policy development and training are discussed.
Working with individuals with dual disabilities can be a complex process in the presence of limit... more Working with individuals with dual disabilities can be a complex process in the presence of limited evidence base to guide clinical practice. The aims of this qualitative study were to investigate perceptions of best practices of Australian psychologists who work with this specialist population. Thirty-eight Australian psychologists working in the intellectual disability field participated in eight semistructured focus groups. Perceptions of evidence-based practice for individuals with intellectual disabilities and in relation to mental health assessment were explored. Psychologists demonstrated resourcefulness in adapting to limits in available evidence-based practice and in modifying mainstream practice to suit the needs of individuals with dual disabilities. Findings suggest the necessity of practice-based evidence in contributing to the evidence base, and person-centered approaches in relation to best practice for people with intellectual disabilities. Implications for strengthening psychologists’ clinical competency and bridging the research and practice gap are discussed.
The aim of this study was to examine carer experiences with mental health services for individual... more The aim of this study was to examine carer experiences with mental health services for individuals with dual disabilities in Australia. This qualitative study involved semi-structured interviews with nine parents with an adult offspring with an intellectual disability in 2016. Parents who had received a mental health service for their offspring within the past two years in Australia with adequate spoken English were included. Parents were asked four open ended questions relating to their experiences of mental health services for their offspring. Findings revealed parents reported more negative experiences with mental health services perceived to hold limited expertise in dual disabilities. They also reported difficulties in accessing appropriate services and highlighted the importance of collaboration and adjustments to suit individual needs of their child. The findings are discussed in terms of the implications for service provision and training for practitioners working with families with intellectual disabilities. Acknowledging the important role of carers as key informants and partners in treatment decision making is highlighted as necessary aligning services with best practice standards.
Research has indicated that adults diagnosed with a primary brain tumor (BT) are susceptible to e... more Research has indicated that adults diagnosed with a primary brain tumor (BT) are susceptible to experiencing anxiety and depressive problems post-diagnosis. However, there is a notable paucity of psychological interventions which have been tested with adult BT patients. An acceptance and commitment therapy (ACT)-based manualized program was developed for anxious and/or depressed BT patients. The preliminary efficacy of this program was initially tested using a proof-of-concept study design based on a case series of four clinically distressed BT patients. Three of the four participants no longer met criteria for anxiety and/or depressive disorders at post-therapy, and these effects were maintained at 3 months of follow-up. The fourth participant, who had a premorbid psychiatric history, experienced a stabilization of anxiety and depressive symptoms. Given the current dearth of studies which have tested psychological interventions for distressed BT survivors, these preliminary findings have promising clinical utility. However, the efficacy of psychological interventions tailored for clinically distressed BT patients needs to be further tested using larger-scale controlled trial designs.
The present study was designed to examine the effects of training in positive interpretations in ... more The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of 87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.
Background: Adult brain tumor (BT) patients and longer-term survivors are susceptible to experien... more Background: Adult brain tumor (BT) patients and longer-term survivors are susceptible to experiencing emotional problems, including anxiety and/or depression disorders, which may further compromise their quality-of-life (QOL) and general well-being. The objective of this paper is to review sychological approaches for managing anxiety and depressive symptoms in adult BT patients. A review of psychological interventions comprising mixed samples of oncology patients, and which included BT patients is also evaluated. The review concludes with an overview of a recently developed transdiagnostic psychotherapy program, which was specifically designed to treat anxiety and/or depressive symptoms in adult BT patients. Methods: Electronic databases (PsycINFO, Medline, Embase, and Cochrane) were searched to identify published studies investigating psychological interventions for managing anxiety and depressive symptoms in adult BT patients. Only four randomized controlled trials (RCTs) were identified. Results: Only one of the RCTs tested a psychosocial intervention, which was specifically developed for primary BT patients, and which was found to improve QOL including existential well-being as well as reducing depressive symptoms. A second study tested a combined cognitive rehabilitation and problem-solving intervention, although was not found to significantly improve mood or QOL. The remaining two studies tested multidisciplinary psychosocial interventions in heterogeneous samples of cancer patients (included BT patients) with advanced stage disease. Maintenance of QOL was found in both studies, although no secondary gains were found for improvements in mood. Conclusion: There is a notable paucity of psychological interventions for adult BT patients across the illness trajectory. Further research is required to strengthen the evidence base for psychological interventions in managing anxiety and depressive symptoms, and enhancing the QOL of distressed adults diagnosed with a BT.
Australian Journal of Psychology, in press (doi: 10.1111/ajpy.12097)
Objective: Research suggests that the way anger is expressed and efforts to control anger may be ... more Objective: Research suggests that the way anger is expressed and efforts to control anger may be particularly important in post-traumatic stress disorder (PTSD). However, factors influencing the association between PTSD symptom severity and anger expression and control, and whether these associations are influenced in part by cognitive processes, have yet to be investigated
in combat veterans. The aim of the present study was to investigate the mediating effect of trauma-related cognitive variables between combat-PTSD symptom severity and anger expression in Australian veterans. Method: A sample of 149 treatmentseeking Australian older-aged veterans with chronic combat-related PTSD completed a battery of measures that assessed combat-PTSD symptom severity, anger indices, trauma-related rumination, cognitive suppression, and trauma appraisals.
Results: Path analyses revealed that negative beliefs about self partially mediated the effect of PTSD symptom severity and anger suppression, and PTSD symptom severity and anger control, while negative beliefs about the world partially mediated the association between PTSD severity and outward expression of anger. A significant direct effect from combat-PTSD symptom severity to outward expression was also found. Conclusions: Findings lend support to targeted assessment and treatment of
negative trauma-related appraisals, particularly negative beliefs about self and the world, to concomitantly enhance anger coping and emotion regulation in middle- to older-aged veterans with chronic combat-related PTSD.
Objective: The aim of the current study was to compare the effects of instructed cognitive reappr... more Objective: The aim of the current study was to compare the effects of instructed cognitive reappraisal, acceptance and emotional suppression on state anger after provocation among individuals with high trait anger. The moderating effects of trait
emotion regulation (ER) styles were also examined. Method: Adults (N=102) with elevated levels of trait anger were randomised to one of three ER conditions. Participants
in both the reappraisal and emotional suppression conditions reported a decline in state anger and systolic blood pressure (SBP) post-anger provocation, whereas participants in the acceptance group did not experience a substantial decline
in state anger or SBP post-anger provocation. Trait suppression was further found to enhance the effects of instructed suppression, while trait tolerance augmented the effects of instructed reappraisal. Conclusions: Support was found for the
use of reappraisal and emotional suppression as adaptive strategies to cope with anger arousal in the short term after provocation.
Cognitive and Behavioral Practice; (In press, 2014); doi: 10.1016/j.cbpra.2014.05.002
Depression and anxiety disorders, including PTSD, are highly prevalent and frequently co-occur in... more Depression and anxiety disorders, including PTSD, are highly prevalent and frequently co-occur in newly diagnosed head and neck cancer (HNC) patients, as well as in longer-term survivors. There is, however, scant empirical
evidence to inform clinicians how to best treat distressed HNC patients, particularly in the initial months following their diagnosis. The present article describes the development of a brief, early cognitive-behavioral intervention (the HNCCBT
program) in treating cancer-related PTSD and/or comorbid anxiety and depressive disorders in recently diagnosed HNC patients. The program was developed to be implemented concurrently with patients’ medical treatment(s) to help
individuals manage their acute anxiety and PTSD reactions, as well as prevent chronic psychopathology in the postmedical treatment recovery phase. A case study is also presented to illustrate how to apply this intervention with
clinically distressed HNC patients. Feasibility issues are also discussed in the implementation of this program during the course of medical treatment.
Stress and Health; (in press, 2014); DOI: 10.1002/smi.2567
The aim of the present study was to investigate whether reduced autobiographical memory and futur... more The aim of the present study was to investigate whether reduced autobiographical memory and future event
specificity were associated with elevated depressive and stress symptoms immediately and 1 week following exposure
to a trauma film. A non-clinical sample comprising 101 participants completed all phases of the study, which
included the following: baseline tests of autobiographical memory and future event specificity; a diary recording
intrusions of the film over a 7-day period; and self-report questionnaires assessing depressive, posttraumatic stress
and ruminative symptoms 7 days following the trauma film viewing. Overgeneral autobiographical memory was
significantly related to deficits in the specificity with which participants imagined future events. Participants who
were more specific when remembering past and imagining future events reported less intrusions related to the
trauma film over the 7-day period following the film; however, event specificity was not associated with depressive
and stress symptoms 7 days later. These findings suggest that reduced past and future event specificity may play a
role in the experience of intrusions following the experience of a stressful event.
Frontiers in Psychiatry; 2013; Open Access; http://www.frontiersin.org/affective_disorders_and_psychosomatic_research/10.3389/fpsyt.2013.00122/full
Australian Journal of Psychology, in press, doi: 10.1111/ajpy.12027, 2013
The objective of the current study was to investigate whether emotion pictorial cues increase mem... more The objective of the current study was to investigate whether emotion pictorial cues increase memory specificity among non-clinical participants. Undergraduate university students were presented with emotion word and pictorial cues on a prompted and nonprompted version of the Autobiographical Memory Test (AMT). In comparison to pictorial cues, participants retrieved significantly fewer specific autobiographical memories in response to word cues on the prompted AMT; however, there was no significant difference on the non-prompted AMT. Participants also retrieved significantly fewer specific memories in response to both word and pictorial cues on the non-prompted AMT compared with the prompted AMT. These results provide support for the hypothesis that among non-clinical participants, visual cues increase memory specificity over and above emotion. Further research is needed to investigate ways in which memory specificity can be increased and the use of imagery may be a promising avenue.
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Papers by Maria Kangas
(CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant
reduction in interpretation bias on the social threat scenarios after training, but not children in
the neutral training group. No effects on interpretation biases were found for the general
threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did
not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social
interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.
may further compromise their quality-of-life (QOL) and general well-being. The objective of this paper is to review sychological approaches for managing anxiety and depressive symptoms in adult BT patients. A review of psychological interventions comprising mixed samples of oncology patients, and which included BT patients is also evaluated. The review concludes with an overview of a recently developed transdiagnostic psychotherapy program, which was specifically designed to treat anxiety and/or depressive symptoms in adult BT patients.
Methods: Electronic databases (PsycINFO, Medline, Embase, and Cochrane) were searched to identify published studies investigating psychological interventions for managing
anxiety and depressive symptoms in adult BT patients. Only four randomized controlled trials (RCTs) were identified.
Results: Only one of the RCTs tested a psychosocial intervention, which was specifically developed for primary BT patients, and which was found to improve QOL including
existential well-being as well as reducing depressive symptoms. A second study tested a combined cognitive rehabilitation and problem-solving intervention, although was not found to significantly improve mood or QOL. The remaining two studies tested multidisciplinary psychosocial interventions in heterogeneous samples of cancer patients (included BT patients) with advanced stage disease. Maintenance of QOL was found in both studies, although no secondary gains were found for improvements in mood.
Conclusion: There is a notable paucity of psychological interventions for adult BT patients across the illness trajectory. Further research is required to strengthen the evidence base for psychological interventions in managing anxiety and depressive symptoms, and enhancing the QOL of distressed adults diagnosed with a BT.
in combat veterans. The aim of the present study was to investigate the mediating effect of trauma-related cognitive variables between combat-PTSD symptom severity and anger expression in Australian veterans. Method: A sample of 149 treatmentseeking Australian older-aged veterans with chronic combat-related PTSD completed a battery of measures that assessed combat-PTSD symptom severity, anger indices, trauma-related rumination, cognitive suppression, and trauma appraisals.
Results: Path analyses revealed that negative beliefs about self partially mediated the effect of PTSD symptom severity and anger suppression, and PTSD symptom severity and anger control, while negative beliefs about the world partially mediated the association between PTSD severity and outward expression of anger. A significant direct effect from combat-PTSD symptom severity to outward expression was also found. Conclusions: Findings lend support to targeted assessment and treatment of
negative trauma-related appraisals, particularly negative beliefs about self and the world, to concomitantly enhance anger coping and emotion regulation in middle- to older-aged veterans with chronic combat-related PTSD.
emotion regulation (ER) styles were also examined. Method: Adults (N=102) with elevated levels of trait anger were randomised to one of three ER conditions. Participants
in both the reappraisal and emotional suppression conditions reported a decline in state anger and systolic blood pressure (SBP) post-anger provocation, whereas participants in the acceptance group did not experience a substantial decline
in state anger or SBP post-anger provocation. Trait suppression was further found to enhance the effects of instructed suppression, while trait tolerance augmented the effects of instructed reappraisal. Conclusions: Support was found for the
use of reappraisal and emotional suppression as adaptive strategies to cope with anger arousal in the short term after provocation.
evidence to inform clinicians how to best treat distressed HNC patients, particularly in the initial months following their diagnosis. The present article describes the development of a brief, early cognitive-behavioral intervention (the HNCCBT
program) in treating cancer-related PTSD and/or comorbid anxiety and depressive disorders in recently diagnosed HNC patients. The program was developed to be implemented concurrently with patients’ medical treatment(s) to help
individuals manage their acute anxiety and PTSD reactions, as well as prevent chronic psychopathology in the postmedical treatment recovery phase. A case study is also presented to illustrate how to apply this intervention with
clinically distressed HNC patients. Feasibility issues are also discussed in the implementation of this program during the course of medical treatment.
specificity were associated with elevated depressive and stress symptoms immediately and 1 week following exposure
to a trauma film. A non-clinical sample comprising 101 participants completed all phases of the study, which
included the following: baseline tests of autobiographical memory and future event specificity; a diary recording
intrusions of the film over a 7-day period; and self-report questionnaires assessing depressive, posttraumatic stress
and ruminative symptoms 7 days following the trauma film viewing. Overgeneral autobiographical memory was
significantly related to deficits in the specificity with which participants imagined future events. Participants who
were more specific when remembering past and imagining future events reported less intrusions related to the
trauma film over the 7-day period following the film; however, event specificity was not associated with depressive
and stress symptoms 7 days later. These findings suggest that reduced past and future event specificity may play a
role in the experience of intrusions following the experience of a stressful event.
(CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant
reduction in interpretation bias on the social threat scenarios after training, but not children in
the neutral training group. No effects on interpretation biases were found for the general
threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did
not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social
interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.
may further compromise their quality-of-life (QOL) and general well-being. The objective of this paper is to review sychological approaches for managing anxiety and depressive symptoms in adult BT patients. A review of psychological interventions comprising mixed samples of oncology patients, and which included BT patients is also evaluated. The review concludes with an overview of a recently developed transdiagnostic psychotherapy program, which was specifically designed to treat anxiety and/or depressive symptoms in adult BT patients.
Methods: Electronic databases (PsycINFO, Medline, Embase, and Cochrane) were searched to identify published studies investigating psychological interventions for managing
anxiety and depressive symptoms in adult BT patients. Only four randomized controlled trials (RCTs) were identified.
Results: Only one of the RCTs tested a psychosocial intervention, which was specifically developed for primary BT patients, and which was found to improve QOL including
existential well-being as well as reducing depressive symptoms. A second study tested a combined cognitive rehabilitation and problem-solving intervention, although was not found to significantly improve mood or QOL. The remaining two studies tested multidisciplinary psychosocial interventions in heterogeneous samples of cancer patients (included BT patients) with advanced stage disease. Maintenance of QOL was found in both studies, although no secondary gains were found for improvements in mood.
Conclusion: There is a notable paucity of psychological interventions for adult BT patients across the illness trajectory. Further research is required to strengthen the evidence base for psychological interventions in managing anxiety and depressive symptoms, and enhancing the QOL of distressed adults diagnosed with a BT.
in combat veterans. The aim of the present study was to investigate the mediating effect of trauma-related cognitive variables between combat-PTSD symptom severity and anger expression in Australian veterans. Method: A sample of 149 treatmentseeking Australian older-aged veterans with chronic combat-related PTSD completed a battery of measures that assessed combat-PTSD symptom severity, anger indices, trauma-related rumination, cognitive suppression, and trauma appraisals.
Results: Path analyses revealed that negative beliefs about self partially mediated the effect of PTSD symptom severity and anger suppression, and PTSD symptom severity and anger control, while negative beliefs about the world partially mediated the association between PTSD severity and outward expression of anger. A significant direct effect from combat-PTSD symptom severity to outward expression was also found. Conclusions: Findings lend support to targeted assessment and treatment of
negative trauma-related appraisals, particularly negative beliefs about self and the world, to concomitantly enhance anger coping and emotion regulation in middle- to older-aged veterans with chronic combat-related PTSD.
emotion regulation (ER) styles were also examined. Method: Adults (N=102) with elevated levels of trait anger were randomised to one of three ER conditions. Participants
in both the reappraisal and emotional suppression conditions reported a decline in state anger and systolic blood pressure (SBP) post-anger provocation, whereas participants in the acceptance group did not experience a substantial decline
in state anger or SBP post-anger provocation. Trait suppression was further found to enhance the effects of instructed suppression, while trait tolerance augmented the effects of instructed reappraisal. Conclusions: Support was found for the
use of reappraisal and emotional suppression as adaptive strategies to cope with anger arousal in the short term after provocation.
evidence to inform clinicians how to best treat distressed HNC patients, particularly in the initial months following their diagnosis. The present article describes the development of a brief, early cognitive-behavioral intervention (the HNCCBT
program) in treating cancer-related PTSD and/or comorbid anxiety and depressive disorders in recently diagnosed HNC patients. The program was developed to be implemented concurrently with patients’ medical treatment(s) to help
individuals manage their acute anxiety and PTSD reactions, as well as prevent chronic psychopathology in the postmedical treatment recovery phase. A case study is also presented to illustrate how to apply this intervention with
clinically distressed HNC patients. Feasibility issues are also discussed in the implementation of this program during the course of medical treatment.
specificity were associated with elevated depressive and stress symptoms immediately and 1 week following exposure
to a trauma film. A non-clinical sample comprising 101 participants completed all phases of the study, which
included the following: baseline tests of autobiographical memory and future event specificity; a diary recording
intrusions of the film over a 7-day period; and self-report questionnaires assessing depressive, posttraumatic stress
and ruminative symptoms 7 days following the trauma film viewing. Overgeneral autobiographical memory was
significantly related to deficits in the specificity with which participants imagined future events. Participants who
were more specific when remembering past and imagining future events reported less intrusions related to the
trauma film over the 7-day period following the film; however, event specificity was not associated with depressive
and stress symptoms 7 days later. These findings suggest that reduced past and future event specificity may play a
role in the experience of intrusions following the experience of a stressful event.