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Research is inconclusive with respect to the possible risk-increasing effect of anxiety symptoms on heavy drinking behavior among adolescents and young adults. Adult role transitions and changes in the social context from early adolescence into young adulthood may impact the association between anxiety symptoms and alcohol use. The TRacking Adolescents' Individual Lives Survey, including 2,229 individuals at baseline, was used to evaluate the bi-directional and longitudinal associations between anxiety symptoms and alcohol use, using data at 14, 16, 19, 22, and 25 years of age. Cross-lagged models revealed a relatively stable negative association at 14, 16, and 19 years, showing that relatively higher anxiety symptoms were associated with relatively lower drinking levels three years later. This effect was absent in young adulthood. There was no evidence for significant associations between alcohol use and subsequent anxiety symptoms, with the exception of alcohol use at age 19, which predicted relatively lower levels of anxiety symptoms at age 22. Overall, the results indicated that anxiety symptoms may withhold adolescents from (heavy) drinking, although this protective effect disappeared in young adulthood. Transitions in social contexts as well as autonomy and adult responsibilities could underlie the changing association between alcohol use and anxiety symptoms throughout adolescence and young adulthood. [ABSTRACT FROM AUTHOR]

Assessing obsessive compulsive disorder (OCD) in paediatric populations is complex, and a number of scales have been developed or validated for this purpose. As is the case with instruments measuring other mental health disorders, it is often assumed that youth OCD scales assess the same construct and can be used interchangeably. However, the extent to which this is true is unknown. One way to assess this – beyond calculating convergent validity – is to measure the extent of content overlap between scales. In the current paper, we apply a recently-developed method of content overlap analysis to a set of freely-available, self-report instruments for OCD measurement that were developed for or validated in paediatric populations. We found a high level of heterogeneity among scales purportedly assessing the same construct. Implications for clinical practice and research are discussed, as well as what further research is required. • Substantial heterogeneity exists among scales purportedly assessing the same OCD construct in youth. • There is greater content overlap between compulsion symptoms probed by youth OCD scales than between obsession symptoms. • Incorporating both convergent validity and content overlap data gives the best picture of the similarity of two given instruments. [ABSTRACT FROM AUTHOR]

Textiles are an emerging class of support material for catalysts, and are available in many different structures at a modest cost from a well-established industry. This review discusses 87 studies of wool and reconstituted wool as catalysts, and supports for catalysts, along with informative complementary studies. The catalytic properties of wool itself were investigated in two studies, and it was shown to be an effective solid sulphonic acid catalyst. A wide variety of catalysts have been applied to wool, i.e. metal complexes, metal oxides, metallic particles, enzymes, microbes and small organic molecules. Wool supported catalysts generally showed good activity, specificity, durability, and re-usability and this is attributable to the amino acid composition of wool enabling a wide range of protocols for attaching catalysts. Reconstituted wool is an effective support for enzyme, metal oxide and organic photoactive catalysts and its low toxicity towards cells makes it a promising support for phototherapy catalysts. This review has shown the wide breadth of research that has been undertaken on wool catalysts and wool-supported catalysts and many interesting developments will be made in the future. For instance, hair and feathers have been used as templates for preparing highly structured materials that may prove effective as catalysts, and wool warrants investigation in this area. Other areas of particular interest for the future are wool sulphonic acid catalysts, and supporting organic molecules onto wool to prepare synthetic enzymes. [ABSTRACT FROM AUTHOR]

The experience of traumatic events has been linked to the development of psychopathology. Changing perspectives on psychopathology have resulted in the hypothesis that broad dimensional constructs account for the majority of variance across putatively distinct disorders. As such, traumatic events may be associated with several disorders due to their relationship with these broad dimensions rather than any direct disorder-specific relationship. The current study used data from 8871 Australians to test this hypothesis. Two broad dimensions accounted for the majority of relationships between traumatic events and mental and substance use disorders. Direct relationships remained between post-traumatic stress disorder and six categories of traumatic events in the total population and between drug dependence and accidents/disasters for males only. These results have strong implications for how psychopathology is conceptualized and offer some evidence that traumatic events are associated with an increased likelihood of experiencing psychopathology in general. [ABSTRACT FROM AUTHOR]

Objective: To investigate factors that may bias the reporting of major depression symptoms among older adults, specifically the presence of physical conditions, bereavement, episode onset, and episode length.Methods: A secondary data analysis of a nationally representative cross-sectional survey of community-dwelling older Australian adults aged 50-85 years who completed the depression module in the 2007 Australian National Survey of Mental Health and Wellbeing (N=629) was conducted. Depression symptomatology was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria using the World Mental Health Composite International Diagnostic Interview.Results: Multiple indicators multiple causes modeling indicated a unidimensional factor structure of depression. Two depressive symptoms displayed measurement noninvariance (i.e., nonequivalency): worthlessness/guilt and suicidality/thoughts of death. Specifically, older adults who were bereaved were significantly less likely to report worthlessness/guilt (OR: 0.29; 95% CI: 0.16-0.50) and more likely to report suicidality/thoughts of death (OR: 4.67; 95% CI: 2.84-7.68), compared with older adults who were not bereaved. Examination of latent mean differences revealed that older adults with physical conditions displayed significantly greater depression severity compared with older adults without physical conditions.Conclusion: The presence of physical conditions and episode onset and length do not appear to differentially influence reporting of depression symptoms among older Australian adults, suggesting these factors do not bias prevalence estimates of depression. Reporting of worthlessness/guilt and suicidality/thoughts of death may be biased toward older adults who are bereaved; however, these did not influence overall depression severity. [ABSTRACT FROM AUTHOR]

The article presents a study aimed at identifying the prevalence and correlates of subjective memory complaints based on data from the Australian National Survey of Mental Health and Well-Being (NSMHWB). It discusses the relation of subjective memory complaints to several negative clinical features that are urged to be considered when interpreting the complaints. Tables showing the associations between worse memory and declining memory complaints and the correlates of interest are shown.

Background: There is a paucity of empirical studies examining the latent structure of depression symptoms within clinical populations. Objective: The current study aimed to evaluate the latent structure of DSM-IV major depression utilising dimensional, categorical, and hybrid models of dimensional and categorical latent variables in a large treatment-seeking population. Methods: Latent class models, latent factor models, and factor mixture models were fit to data from 1165 patients currently undergoing online treatment for depression. Results: Model fit statistics indicated that a two-factor model fit the data the best when compared to a one-factor model, latent class models, and factor mixture models. Conclusions: The current study suggests that the structure of depression consists of two underlying dimensions of depression severity when compared to categorical or a mixture of both categorical and dimensional structures. For clinical samples, the two latent factors represent psychological and somatic symptoms. [ABSTRACT FROM AUTHOR]

The article discusses research in geriatric psychiatry, with a focus on the use of the 10-Item Kessler Psychological Distress Scale (K10) as an instrument for screening older people. Topics include surveys of mental health and well-being, predictive power and curve analysis, and anxiety or affective disorders as listed in the Diagnostic and Statistical Manual of Mental Disorders.

Abstract: Internet based cognitive behavioural therapy (CBT) is efficacious for the treatment of anxiety and depression. The current study aimed to examine the effectiveness of internet based CBT prescribed by primary care clinicians for the treatment of depression and generalised anxiety disorder. Psychological distress data from 302 patients who completed an online CBT course for depression and 361 patients who completed an online CBT course for generalised anxiety disorder were subjected to growth mixture analysis. For both disorders psychological distress decreased across each lesson in a quadratic trend. Two classes of individuals were identified with different trajectories of change: a large group of individuals who responded well to the courses and a smaller group of individuals with a lower response. Both groups were similar with respect to socio-demographic characteristics however the Low Responders tended to have higher levels of symptom severity and psychological distress at baseline in comparison to the responders. For the majority of patients (75–80%) the internet CBT courses for depression and generalised anxiety disorder were effective. Further research is required to identify and effectively treat the smaller proportion of patients who did not improve during internet CBT. [Copyright &y& Elsevier]

Abstract: Background: Estimates of the prevalence of mental disorders are vital for policy and practice. The aim of the current study was to compare estimates of point (30-day) prevalence of major depressive episode (MDE) derived from a lifetime diagnostic interview with estimates derived from an interview exclusively focussing on the 30 days prior to interview. Methods: Study design consisted of face-to-face survey interviews using two separate versions (lifetime and current) of the depression module of the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (WMH-CIDI). The setting was an outpatient tertiary referral centre for the treatment of anxiety and depressive disorders. One hundred and sixty four people were randomly allocated to receive either the lifetime or current version of the WMH-CIDI. Point prevalent cases derived from the lifetime interview were compared to point prevalent cases comprehensively assessed by the current interview. Results: The risk of being diagnosed with current MDE having been interviewed with a lifetime interview was higher, but not significantly higher, than the risk of being diagnosed with current MDE having been interviewed with a current interview (RR=1.29, 95% CI: 0.82–2.03). Derived and comprehensive point prevalent cases were similar with regard to a range of depression-related clinical characteristics. Limitations: The size of the sample precluded the ability to determine the equivalence of prevalence estimates. The observed relationships may be different in general community samples. Conclusions: Point prevalence of MDE derived from a lifetime diagnostic interview may be slightly higher than that derived from a comprehensive current interview. However, point prevalent cases, regardless of how they are derived, are similar with regard to depression-related clinical characteristics. [Copyright &y& Elsevier]

A large body of research has emerged over the last decade examining empirical models of general and specific psychopathology, which take into account comorbidity among psychiatric disorders and enable investigation of risk and protective factors that are common across disorders. This systematic review presents findings from studies of empirical models of psychopathology and transdiagnostic risk and protective factors for psychopathology among young people (10–24 years). PsycInfo, Medline and EMBASE were searched from inception to November 2020, and 41 studies were identified that examined at least one risk or protective factor in relation to broad, empirically derived, psychopathology outcomes. Results revealed several biological (executive functioning deficits, earlier pubertal timing, genetic risk for ADHD and schizophrenia, reduced gray matter volume), socio-environmental (stressful life events, maternal depression) and psychological (low effortful control, high neuroticism, negative affectivity) transdiagnostic risk factors for broad psychopathology outcomes, including general psychopathology, internalising and externalising. Methodological complexities are discussed and recommendations for future studies of empirical models of psychopathology are presented. These results contribute to a growing body of support for transdiagnostic approaches to prevention and intervention for psychiatric disorders and highlight several promising avenues for future research. • First systematic review of empirical models of psychopathology and risk and protective factors. • Biological: executive functioning deficits, earlier pubertal timing, genetic risk, gray matter volume. • Socio-environmental: stressful life events, maternal depression. • Psychological: Low effortful control, high neuroticism/negative affectivity. • More multidisciplinary, longitudinal, causally driven research needed. [ABSTRACT FROM AUTHOR]

Abstract Background There is substantial evidence that psychosocial programs delivered online can be effective in treating and preventing mental health problems. However, use of evidence-based programs in the community is currently suboptimal, and there is a lack of evidence around how to increase engagement with existing evidence-based programs. Novel approaches to increasing the acceptability of online programs such as the use of brief engagement-facilitation interventions (EFI) require evaluation. Aims The aims of this study are to 1) examine the effectiveness of a brief online engagement-facilitation intervention (EFI) presented prior to an online self-help mental health program (myCompass) in improving uptake of and adherence to that program, and 2) assess if greater uptake and/or adherence are associated with improved efficacy (greater reduction in symptoms of depression and anxiety) relative to a control condition). Methods A three-arm randomized controlled trial will be conducted (target sample: N = 693 participants recruited via social media). An active online cognitive behavioral therapy (iCBT) intervention will be delivered either with (arm 1) or without (arm 2) the EFI. An attention control group (arm 3) will enable testing of the relative efficacy of the iCBT intervention. Primary outcomes are uptake of the intervention (initiation) and adherence (module completion). Results Findings will inform the more efficient dissemination of a range of psychosocial programs into the community, with potential for significant efficiency gains in treating common mental health problems. Conclusions Greater engagement with online psychosocial programs may lead to significant reductions in the burden of common mental health problems in the community. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618001565235. [ABSTRACT FROM AUTHOR]

The current study examined associations between preconception diagnoses of major depressive disorder (MDD) and anxiety disorders in adolescence and young adulthood and perinatal depression and anxiety symptoms in early fatherhood. In an Australian community cohort study of health and development, earlier history of MDD and anxiety disorders (extending back to adolescence) were assessed retrospectively in the third trimester of pregnancy via the Composite International Diagnostic Interview. Paternal perinatal depression and anxiety were then assessed prospectively over three timepoints (third trimester of pregnancy, 8 weeks and 12 months postpartum), using established cut-points on the Edinburgh Postnatal Depression Scale and the Depression Anxiety Stress Scales (anxiety subscale). Mixed-effects regression models examined risk associations between preconception diagnoses of MDD and anxiety disorders, and perinatal depression and anxiety symptoms at each timepoint, adjusting for socio-demographic factors and concurrent maternal mental health difficulties. The odds of clinically concerning levels of paternal perinatal depression and anxiety were 6-fold and 4-fold higher, respectively, in men with a preconception history of MDD. The odds of perinatal depression were 3-fold higher in men with a preconception history of an anxiety disorder. Less evidence was found for an association between preconception diagnoses of an anxiety disorder and perinatal anxiety in fathers. Interventions aimed at improving mental health in men during adolescence and young adulthood may promote continued psychological health in men during early fatherhood. [ABSTRACT FROM AUTHOR]

Objective: Alcohol use is a leading cause of burden of disease among young people. Prevention strategies can be effective in the short-term; however little is known about their longer-term effectiveness. The aim of this study was to examine the sustainability of universal, selective, and combined alcohol use prevention across the critical transition period from adolescence into early adulthood.Method: In 2012, a total of 2190 students (mean age, 13.3 years) from 26 Australian high schools participated in a cluster randomized controlled trial and were followed up for 3 years post baseline. Schools were randomly assigned to deliver the following: (1) universal Web-based prevention for all students (Climate Schools); (2) selective prevention for high-risk students (Preventure); (3) combined universal and selective prevention (Climate Schools and Preventure [CAP]); or (4) health education as usual (control). This study extends the follow-up period to 7-years post baseline. Primary outcomes were self-reported frequency of alcohol consumption and binge drinking, alcohol-related harms, and hazardous alcohol use, at the 7-year follow-up.Results: At 7-year follow-up, students in all 3 intervention groups reported reduced odds of alcohol-related harms compared to the control group (odds ratios [ORs] = 0.13-0.33), and the Climate (OR = 0.04) and Preventure (OR = 0.17) groups reported lower odds of hazardous alcohol use. The Preventure group also reported lower odds of weekly alcohol use compared to the control group (OR = 0.17), and the Climate group reported lower odds of binge drinking (OR = 0.12), holding mean baseline levels constant.Conclusion: This study demonstrated that both universal and selective preventive interventions delivered in schools can have long-lasting effects and reduce risky drinking and related harms into adulthood. No added benefit was observed by delivering the combined interventions.Clinical Trial Registration Information: The CAP Study: Evaluating a Comprehensive Universal and Targeted Intervention Designed to Prevent Substance Use and Related Harms in Australian Adolescents; https://www.anzctr.org.au/; ACTRN12612000026820. [ABSTRACT FROM AUTHOR]

Background: Stepped-care is a commonly recommended and implemented care model across health care domains, including substance use. Despite their presumed efficient allocation of treatment resources, a current and robust evidence synthesis is needed on the efficacy, effectiveness and cost-effectiveness of stepped-care for substance use.Methods: This systematic review analyzed articles describing evaluations of stepped-care models that measured the use of acutely psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in participants over 18 years old. The analysis investigated model and participant characteristics associated with treatment outcomes.Results: The study team conducted a search of five databases of literature (PsychINFO, MEDLINE, Embase, Cochrane Library and Scopus) published between January 1, 2010, and November 1, 2020. The search yielded 1051 unique articles, 19 of which were included in the analysis. The studies had considerable variability in sample sizes (n = 18-2310), time to follow-up (4.5 months to 3 years), and retention rates (35.1-100 %). Studies examined outcomes for either alcohol alone (n = 9), alcohol and other drug use (n = 9), or drug use alone (n = 1). Most studies (n = 13;) were rated as good quality. Three (15.8 %) were rated as fair and three (15.8 %) were rated as poor quality. The evidence regarding the efficacy, effectiveness and cost-effectiveness of stepped-care approaches is limited, but four of seven studies found that adaptive-care interventions delivered in the context of other systemic interventions produced greater benefit than control conditions in relation to at least one alcohol-related outcome. We have insufficient evidence to determine whether the modes or intensity of interventions included in the models, or decision rules used to step people up or down to differing levels of care, have an impact on outcome.Conclusion: Heterogeneity between studies with regard to model and evaluation design limited the degree to which the analysis could draw robust conclusions. Sample recruitment and statistical power are particular challenges, and the field needs more innovative evaluation designs to assess the efficacy, effectiveness, and cost-effectiveness of stepped-care models. [ABSTRACT FROM AUTHOR]

Objectives Given high rates of comorbidity among mental disorders, better methods to rapidly screen across multiple mental disorders are needed. Building on existing Patient Reported Outcomes Measurement Information System (PROMIS) item banks, the present study aimed to select items to assess panic disorder, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, adult attention-deficit hyperactivity disorder, substance use disorder, suicidal thoughts and behaviors, and psychosis. Study Design and Setting A four-stage process to select items involved systematic literature searches, item refinement and standardization, obtaining feedback from consumers and experts, and reduction of item pools in preparation for calibration in a population-based sample. Results From 6,900 items collected across the eight mental health conditions, 2,002 were standardized and rated by small groups of consumers and experts. Expert ratings of item relevance tended to correlate moderately with consumer ratings, with variation across conditions. An algorithm was used to generate final item pools ranging from 45 to 75 items. Conclusion The study successfully applied a systematic process to select items for assessing a range of mental disorders. This process for item selection may be applied to additional mental and physical health conditions. The calibration of the present item pools into final item banks will enable the development of flexible measures to assess risk of mental health problems, although more effectively accounting for comorbidity. [ABSTRACT FROM AUTHOR]

Abstract: Since 2009, the Clinical Research Unit for Anxiety and Depression (CRUfAD) has been providing primary care clinicians with internet cognitive behaviour therapy (iCBT) courses to prescribe to patients. Although these courses have demonstrated efficacy in research trials, adherence in primary care is less than half that of the research trials. The present studies pose three questions: first, do course non-completers drop out because of lack of efficacy? Second, can changes in delivery (e.g. adding choice, reminders and financial cost) improve adherence? Last, does clinician contact improve adherence? The results showed that non-completers derive benefit before dropping out; that adding reminders, choice of course and timing, and financial cost can significantly improve adherence; and that clinician contact during the course is associated with increased adherence. It is concluded that improved adherence is an important determinant of effectiveness. [Copyright &y& Elsevier]

Objective: Globally, the prevalence of hazardous drinking peaks in young adulthood, and there is mixed evidence on whether internalising symptoms and executive functioning deficits are associated with this increased risk. This study tested whether internalising symptoms in interaction with executive functioning deficits are associated with high alcohol use disorder symptoms in emerging adulthood, via drinking motives to cope with negative affect and alcohol consumption.Method: An Australian sample of 155 young adults aged 17 to 24 years (M = 20.97, SD = 2.40) provided self-report data on internalising symptom severity and alcohol-related outcomes (n = 155), and neuropsychological data measuring executive functioning (n = 104). Confirmatory factor analyses were conducted to identify two latent variables representing internalising symptoms and executive functions. A series of latent moderated structural equation models and a latent mediated moderation structural equation model examined the inter-relations between internalising symptoms, executive functions and alcohol measures.Results: High levels of internalising symptoms in interaction with executive functioning deficits were associated with strong drinking motives to cope with negative affect, high past month alcohol consumption and greater alcohol use disorder symptoms. Drinking motives to cope with negative affect and alcohol consumption mediated the relationship between the internalising symptoms and executive functioning latent interaction term with alcohol use disorder symptoms.Conclusions: This research highlights greater executive functioning resources are associated with low desires to drink hazardous amounts of alcohol as a maladaptive way to cope with negative feelings among young people. It therefore may be useful to target executive functioning ability alongside internalising symptomology in alcohol prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

Objective: To investigate the contribution of nine mental/substance use disorders to fatigue and sleep disturbance.Methods: 3620 Australians aged 18 years or older recruited from the general community via Facebook during January-February 2016 completed an online survey assessing demographic characteristics, diagnosed medical conditions and nine mental disorders. Outcome measures were Patient Reported Outcomes Measurement Information System (PROMIS®) fatigue and PROMIS sleep disturbance.Results: Overall, 56% of the sample met criteria for at least one mental disorder. Linear regression models of sleep disturbance revealed all mental disorders except obsessive compulsive disorder (β = 0.038) had independent associations with sleep disturbance, with generalised anxiety disorder (GAD) (β = 0.173), major depressive disorder (MDD) (β = 0.117) and post-traumatic stress disorder (PTSD) (β = 0.111) making the greatest contribution. Inclusion of fatigue in the model attenuated the effects of panic disorder, MDD and attention-deficit hyperactive disorder (ADHD) to non-significance. For the outcome of fatigue, GAD (β = 0.223), MDD (β = 0.176) and PTSD (β = 0.147) made the greatest contributions, although all disorders had significant independent relationships. After adjusting for sleep disturbance, all mental disorders continued to make a significant contribution except for alcohol use disorder and substance use disorder.Conclusion: Sleep disturbance and fatigue have independent associations with many mental disorders after correcting for comorbidity and known confounds. The disorders providing the greatest contribution to sleep disturbance and fatigue were GAD and MDD. Sleep disturbance and fatigue may be appropriate transdiagnostic targets for improving symptoms and global functioning for people with mental disorders. [ABSTRACT FROM AUTHOR]