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Objective To investigate whether depression, anxiety and stress increase the risk for delirium and poor quality of life (QOL) after coronary artery bypass (CABG) surgery. Methods A total of 180 CABG patients (mean age of 63.5 ± 10.1 years, 82.2% males) completed baseline and postoperative self-report questionnaires to assess distress and QOL. Incident delirium was diagnosed postoperatively with a structured clinical interview and patients were monitored every day post-operatively for confusion and disturbance in consciousness. Results Delirium developed in 63 persons (35% of sample). After adjustment for covariates, delirium was significantly associated with depression [odds ratio (OR): 1.08; 95% confidence interval (CI): 1.03–1.13, P = 0.003], anxiety (OR: 1.07; 95% CI: 1.02–1.13, P = 0.01) and stress (OR: 1.05; 95% CI: 1.00–1.09, P = 0.03). Preoperative depression scores were associated with poorer QOL including bodily pain (β = −0.39, P = 0.013), vitality (β = −0.32, P = 0.020), social functioning (β = −0.51, P ≤ 0.001), emotional role function (β = −0.44, P = 0.003) and general health (β = −0.33, P = 0.038). Among the covariates, harmful levels of alcohol use was consistently associated with poorer QOL. Conclusions Depression and harmful levels of alcohol use were consistently associated with poorer QOL whereas depression, anxiety and stress were associated with delirium risk. These findings point to further research examining depression and harmful levels of alcohol use in coronary heart disease populations undergoing coronary revascularization.

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.

Objective: To investigate correlates of Australian university students' help-seeking intentions and actual service usage, testing and extending new models based on the Theory of Planned Behaviour and the Behavioural Model of Health Services Use. Method: 611 Australian domestic students (209 males and 402 females, mean age=21years; SD = 5.6) completed standardised measures and commented on facilitators, barriers, benefits, and potential improvements to student mental health services. Results: A model based on Chinese university student data also fit the Australian data best. Bootstrapping revealed relationships between several predictors (knowledge concerning mental health and services, evaluated and perceived need, anticipated benefits, stigma concerns, and Asian values) and help-seeking intentions were significantly mediated by attitudes toward help-seeking and subjective norms. Logistic regression analysis identified predictors of service usage: help-seeking intentions, perceived behavioural control, gender, study major, knowledge of mental health, social support, income, self-rated mental health status, perceived need for help, and Asian values. Refereed/Peer-reviewed

This study explored the impact on consciousness development of participating in either standard or enhanced community leadership programs (CLPs) in Australia. Aligned with Manners' and Durkin's (2000) conceptual framework, CLPs offer experiences that are interpersonal, emotionally engaging, personally salient and structurally disequilibriating for later conventional consciousness stages. Enhanced CLPs include additional psychosocial challenges. Participants were 335 adults who took part in one of 4 standard CLPs, 7 enhanced CLPs and 2 (control) management programs. Modal program length was 10 months. Standard and enhanced CLPs were successful in facilitating consciousness development (as measured by the Washington University Sentence Completion Test—WUSCT) within the conventional stages. However, enhanced CLPs were significantly more successful in triggering post-conventional development, and specifically in those participants who had a preference for Sensing (as measured by the Myers–Briggs Type Indicator—MBTI). Enhanced CLPs could provide a model for other development programs aimed at promoting post-conventional consciousness.

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. Refereed/Peer-reviewed