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Abstract: Dorstyn D, Mathias J, Denson L, Robertson M. Effectiveness of telephone counseling in managing psychological outcomes after spinal cord injury: a preliminary study. Objective: To determine whether an individualized counseling intervention delivered by telephone—telecounseling—feasibly improves the emotional adjustment of adults with a newly acquired spinal cord injury (SCI). Design: Randomized controlled trial. Setting: Spinal injuries unit of a rehabilitation center. Participants: Adults (N=40) aged 18 or older, who were recently discharged home from inpatient spinal rehabilitation, were randomly assigned to a telecounseling treatment or standard-care control group. All participants had recently received psychological treatment as inpatients in order to help assist them in adjusting to their disability. Referral to the inpatient psychology service was therefore a key indicator of participants'' baseline distress levels and, consequently, their need for counseling support postdischarge. Intervention: Seven telecounseling sessions were delivered over a 12-week period by a single psychologist (D.D.). Pre- and postintervention data, plus a 3-month follow-up assessment, were compared with that of an SCI control group who received standard care. Main Outcome Measures: Psychosocial outcome was measured using the following: Depression Anxiety Stress Scale-21; Mini International Neuropsychiatric Interview; Spinal Cord Lesion Emotional Wellbeing and Coping Strategies Questionnaires; and the Multidimensional Measure of Social Support. Cost-effectiveness and clinical feasibility were also evaluated. Results: Telecounseling participants reported clinical improvements in depression and anxiety and aspects of SCI coping immediately postintervention. However, these treatment gains were not statistically significant. Additionally, treatment effects were minimal at 3-month follow-up. Delivery related outcomes, including participation rate and cost analyses, were all positive. Conclusions: The results suggest that continued psychological services for individuals reporting distress during their inpatient rehabilitation is important and that such services can be delivered by telephone cost-effectively and efficiently. However, the long-term benefits of telecounseling, once ceased, were not demonstrated. [Copyright &y& Elsevier]

Abstract: Background: Health literacy is understudied in the mentally ill population, yet it is clear that a high level of health literacy is essential for successful management of illnesses such as schizophrenia and depression. To investigate health literacy in people with mental illness living in urban Australia, and to evaluate the relationships between medication adherence and health literacy. Method: Thirty people with schizophrenia and 30 with major depression were assessed with Test of Functional Health Literacy in Adults (TOFHLA). Discussion: The level of health literacy in our mentally ill participants was comparable with that of the general Australian public, and considerably higher than the rates of health literacy reported in US studies. There appear to be national differences in health literacy, which limit comparison between studies undertaken in different countries. There was no association between health literacy and medication compliance. Our results suggest that poor health literacy does not explain medication nonadherence in people with schizophrenia or depression living in Australia. [Copyright &y& Elsevier]

Objective: There are few prospective comprehensive controlled studies of the neuropsychiatric outcome in people who attempt suicide with carbon monoxide (CO). The present study aimed to evaluate this.Methods: A consecutive series of 41 adults (81% men) with CO exposure presenting over 3 years, and 20 matched controls, were evaluated with instruments to assess orientation, attention, concentration, speed of information processing, verbal memory, premorbid intellect, executive function (working memory, verbal fluency and set-switching), mood disorder, psychotic disorder, alcohol dependence and obsessive-compulsive disorder, levels of depression, hopelessness, suicide intent, anxiety, neurobehavioural function and social and interpersonal functioning. At 2 months follow-up, the neuropsychological battery was extended to include further tests of executive function (including problem-solving) and memory (including visual memory),Results: At initial assessment, control subjects showed similar levels of cognitive impairment as CO-exposed subjects (except in the case of four CO subjects with very severe impairment), but were more depressed. At 2-months follow-up, the trends were generally towards improvement in all subjects, with no between-group differences.Conclusions: Indirect effects on cognitive state may be at least as great as direct CO neurotoxicity in suicide attempters. The study did not support CO exposure exacerbating mood disorder in this sample. [ABSTRACT FROM AUTHOR]

Context: Although previous research has, overall, suggested a moderate relationship between response expectancies (REs) and cancer treatment-related side effects, empirical results have been mixed.Objectives: We aimed to further explore these relationships, hypothesizing that REs would predict subsequent toxicities with the inclusion of more recent studies, across a broader range of side effects, while incorporating the impact of potential moderators including patients' experience with treatment and measurement methods. We further investigated the impact of REs across individual toxicities.Methods: A systematic search and analysis were conducted across four databases (PsychInfo, PubMed, CINAHL, and Embase) and reference lists, from 1985 to February 2016. This provided 27 eligible studies with 4474 participants, through which the main analysis, moderator analyses, and individual side-effect analyses were explored.Results: REs were moderately related to side effects overall (r = 0.26), and effect sizes were significantly influenced by sample diagnostic homogeneity, whereas differences between type and timing of measurement showed trends. Of the 16 toxicities examined, 15 demonstrated significant relationships between REs and side-effect experience, with hair loss (r = 0.48) the strongest. No clear difference emerged between objective and subjective side effects; however, significant differences across individual toxicities were revealed.Conclusion: Findings support a relationship between REs and a wide range of subsequent side effects, yet differences between individual RE-toxicity associations emerged. These findings provide direction for the measurement of side effects and REs and support REs as potential targets for intervention during the informed consent process. [ABSTRACT FROM AUTHOR]

Background and Aims: Mothers who are primary carers of children with disabilities experience more mental health problems than mothers of typically developing children. We aimed to update and extend research into mothers' perceptions of grandparent support with care, and impacts for maternal psychological well-being, because although contemporary grandparents live longer they also work longer.Methods: Surveys were completed by 72 mothers of clients (aged ≤8 years) of an Australian non-government disability agency. Mothers reported levels of practical and emotional support, face-to-face contact, and affectional solidarity with maternal and paternal grandparents. The Kessler Psychological Distress Scale (K10) was the dependent variable.Results: Mothers indicated high to very high levels of psychological distress. As in previous comparable surveys, most support was offered by maternal grandmothers who had more contact and closest relationships with mothers. Maternal distress was related to maternal grandmothers' health and relationships with maternal grandfathers. Face-to-face contact and closeness of relationships were strongly linked to provision of support.Conclusions and Implications: Grandparents are important supports for mothers of children with disabilities: mothers lacking support from their own parents are particularly vulnerable. Clinicians should actively facilitate grandparent involvement, and promote extended family relationships. [ABSTRACT FROM AUTHOR]

Abstract: Pathological gambling is known to be associated with a higher than average prevalence of psychological co-morbidities including a range of psychiatric conditions. A problem with much of this literature, however, is that such problems are also frequently found in populations affected by alcohol use disorder, which is common in populations of pathological gamblers. Accordingly, the principal aim of this study was to profile the comorbidities present in a sample of pathological gamblers, comparing those who did, and did not, additionally meet criteria for alcohol use disorder. A sample of 140 community-recruited regular gamblers completed a number of measures including the Mini International Neuropsychiatric Interview, the Personality Diagnostic Questionnaire, NORC DSM-IV Screen Self-Administered and the Alcohol Use Disorders Identification Test. Comparisons showed that most psychiatric conditions (and in particular personality disorders) were significantly more prevalent in those with a dual diagnosis, followed by problem gamblers and then by those with neither disorder. This suggests that high rates of psychiatric illness in pathological gambling may be strongly influenced by co-occurring alcohol problems. [Copyright &y& Elsevier]

Objective: This randomized controlled trial aimed to determine whether an interactive CD-ROM improved cancer patients’ recall of chemotherapy treatment information over standard written information, and whether demographic, cognitive, and psychological factors better predicted recall than this format of delivery. Methods: One-hundred-and-one new patients about to commence chemotherapy were randomized to receive written information or a CD-ROM containing treatment information before giving informed consent. Patients’ recall, concentration, short-term memory, reading comprehension, anxiety, depression, and coping styles were assessed with standardized measures pre-treatment. Seventy-seven patients completed tests for recall of treatment information before their second chemotherapy session. Results: Intention-to-treat analyses indicated no significant differences between the written information and CD-ROM groups across recall questions about number of drugs received (p =.43), treatment length (p =.23), and treatment goal (p =.69). Binary logistic regressions indicated that for groups combined different variables predicted each of the recall questions. Conclusion: An interactive CD-ROM did not improve cancer patients’ recall of treatment information enough to warrant changes in consent procedures. Practice implications: Different variables predicted recall of different treatment aspects highlighting the complex nature of attempting to improve patient recall. Attending to the effect of depression on patient knowledge and understanding appears paramount. [Copyright &y& Elsevier]

Objective: Response expectancies of cancer treatment toxicities are often, but not always, associated with subsequent experiences. A recent meta-analysis indicated that response expectancies, measured using different assessment formats, reveal different effect sizes, potentially explaining mixed outcomes. Utilizing a clinical sample, we compared 5-point assessments and visual analogue scales, as measures of response expectancies for the incidence and severity of subsequent toxicities.Methods: Four weeks pre-radiotherapy, 45 men with prostate cancer rated their response expectancies of the same 18 toxicities on 5-point assessments and visual analogue scales, presented in random order. Descriptors anchored each end of visual analogue scales and every point of 5-point assessments was labelled, including an 'unsure' midpoint. Toxicities were subsequently assessed 2-weeks into radiotherapy on 100-point visual analogue scales.Results: Across all toxicities, 17.5-62.8% of patients selected 'unsure' on 5-point assessments. No response expectancies were reported on 5-point assessments for 'blood in stools' or 'rectal urgency' yet 54.8%-64.3% of patients indicated response expectancies for these toxicities on visual analogue scales. Visual analogue scales and 5-point scales demonstrated small-to-moderate associations (r = 0.30-0.58) as measures of response expectancy incidence, but mostly large associations when visual analogue scales captured severity (r = 0.43-0.76). Response expectancies measured with visual analogue scales predicted more toxicities to a moderate degree or greater (68.8%) than 5-point assessments (37.5%).Conclusion: This novel investigation demonstrated an 'unsure' midpoint is often selected, potentially reducing the sensitivity of 5-point assessments. Based on their associations, and outcomes, these assessment formats should be considered independent in response expectancy research of cancer treatment toxicities. [ABSTRACT FROM AUTHOR]

Context: Previous research has indicated that pretreatment response expectancies of side effects often predict subsequent toxicity severity. However, this has been largely based on female patients undergoing chemotherapy.Objectives: We tested whether this association also occurred in a novel cohort, men with prostate cancer undergoing radiotherapy. We investigated these associations throughout treatment (before and after side effects were medically predicted to occur), controlling known and novel variables.Methods: Homogenous male patients scheduled for radiotherapy (N = 35, mean age 71 years) completed baseline (pretreatment) measures; response expectancies of 18 treatment-related side effects; questions about baseline health and hormonal treatment, emotional state, and coping style. Response expectancies of the side effects were again measured two weeks into treatment. The severity of the same 18 toxicities was assessed two and seven weeks into treatment.Results: Hierarchical multiple linear regressions revealed baseline response expectancies significantly and independently predicted six of 18 toxicities two weeks into radiotherapy, contributing 12%-30% of explained variance (β = 0.39-0.59). Response expectancies assessed two weeks into treatment significantly and uniquely predicted seven of 17 experienced toxicities at seven weeks, explaining 17%-50% of variance (β = 0.49-0.91). Sexual toxicity response expectancies revealed the strongest associations with experience throughout treatment (β = 0.46-0.91), with "inability to reach orgasm" showing the largest effect.Conclusion: In this older male sample, response expectancies of side effects predicted experiences throughout treatment, including the period before toxicities were medically expected. Response expectancies of sexual side effects were robust, independent predictors of subsequent toxicities across treatment, especially issues with orgasm, warranting focus in practice and future research. [ABSTRACT FROM AUTHOR]