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Objectives: To determine whether elder abuse can predict mortality and disability over the ensuing 12 years., Design: Population-based prospective cohort study of women aged 70 to 75 in 1996; survival analysis., Setting: Australia., Participants: Twelve thousand sixty-six women with complete data on elder abuse., Measurements: Elder abuse was assessed using the 12-item Vulnerability to Abuse Screening Scale (VASS) subscales: vulnerability, coercion, dependence, and dejection. Outcomes were death and disability (defined as an affirmative response to "Do you regularly need help with daily tasks because of long-term illness, disability or frailty?")., Results: In 1996, 8% reported vulnerability, 6% coercion, 18% dependence, and 22% dejection. By October 2008, 3,488 (29%) had died. Mortality was associated with coercion (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.06-1.40) and dejection (HR = 1.12, 95% CI = 1.03-1.23), after controlling for demographic characteristics, social support, and health behavior but not after adding chronic conditions to the coercion model. Over the 12 years, 2,158 of 11,027 women who had reported no disability in 1996 reported disability. Women who reported vulnerability (HR = 1.25, 95% CI = 1.06-1.49) or dejection (HR = 1.55, 95% CI = 1.38-1.73) were at greater risk of disability, after controlling for demographic characteristics, social support, and health behavior. The relationship remained significant for dejection when chronic conditions and mental health were included in the model (HR = 1.40, 95% CI = 1.24-1.58)., Conclusion: Specific components of vulnerability to elder abuse were differently associated with rates of disability and mortality over the ensuing 12 years., (© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.)

Objective: To examine associations between poor mental health and sociodemographic, psychosocial and health related variables in midlife Australian women., Method: The random population-based sample comprised 13,961 Australian women aged 45-50 years who participated in the baseline postal survey for the Australian Longitudinal Study on Women's Health, conducted in 1996. The outcome measure, poor mental health status, was measured by the Mental Health Index (MH) of the SF-36., Results: Sociodemographic factors associated with poor mental health were low educational levels, being unemployed or engaged solely in home duties, and non-English speaking background (European). Health related factors independently associated with poor mental health were having five or more visits to the doctor in the past year, menopausal status (surgical and peri-menopausal), less exercise, and smoking 20 or more cigarettes per day. Among psychosocial variables, low satisfaction with partner or close relationships, low perceived social support outside family, and more life-events over the past 12 months were independently associated., Conclusion: The findings suggest a number of areas in which preventive interventions could be strengthened to improve quality of life among mid-aged women. These include policy changes to promote and support more education and employment opportunities for women before they reach midlife, increase understanding of the link between health risk behaviours and psychological well-being, and provide counselling services to improve women's relational and psychosocial circumstances.

Family mediation is mandated in Australia for couples in dispute over separation and parenting as a first step in dispute resolution, except where there is a history of intimate partner violence. However, validation of effective well-differentiated partner violence screening instruments suitable for mediation settings is at an early phase of development. This study contributes to calls for better violence screening instruments in the mediation context to detect a differentiated range of abusive behaviors by examining the reliability and validity of both established scales, and newly developed scales that measured intimate partner violence by partner and by self. The study also aimed to examine relationships between types of abuse, and between gender and types of abuse. A third aim was to examine associations between types of abuse and other relationship indicators such as acrimony and parenting alliance. The data reported here are part of a larger mixed method, naturalistic longitudinal study of clients attending nine family mediation centers in Victoria, Australia. The current analyses on baseline cross-sectional screening data confirmed the reliability of three subscales of the Conflict Tactics Scale (CTS2), and the reliability and validity of three new scales measuring intimidation, controlling and jealous behavior, and financial control. Most clients disclosed a history of at least one type of violence by partner: 95% reported psychological aggression, 72% controlling and jealous behavior, 50% financial control, and 35% physical assault. Higher rates of abuse perpetration were reported by partner versus by self, and gender differences were identified. There were strong associations between certain patterns of psychologically abusive behavior and both acrimony and parenting alliance. The implications for family mediation services and future research are discussed. [ABSTRACT FROM AUTHOR]

Objective University students have a high risk of psychological distress; however, few Australian studies have specifically examined the prevalence of, or risk factors for, depressive symptoms. This study aimed to examine the prevalence of depressive symptoms among university students and the characteristics of those with depressive symptoms. Method Participants were randomly selected university students at a large metropolitan university in Victoria, Australia. An online survey was administered in May 2009 to assess depressive symptoms using the Depression Anxiety Stress Scale (dependent variable) and a broad range of independent variables including students' demographic, study, psychosocial, and mental health characteristics. Hierarchical multiple regression was used to examine characteristics of those with depressive symptoms. Results Results estimated the prevalence of mild to extremely severe depressive symptoms as 39.5% among the 800 respondents, with 13% in the severe/extremely severe range. The best-fit regression model accounted for 63% of variance in depressive symptoms. Factors associated with higher depressive symptomatology included high anxiety, stress, and loneliness, low body appreciation, studying law/management, regular binge drinking, and less physical activity. Conclusions The implications of our findings include the need for further action by higher education policy and decision-makers and more integrated approaches to the development of resilience, mental health promotion, and early intervention among this vulnerable student population. [ABSTRACT FROM AUTHOR]

Background: Mental health professionals face unique demands and stressors in their work, resulting in high rates of burnout and distress. Clinical supervision is a widely adopted and valued mechanism of professional support, development, and accountability, despite the very limited evidence of specific impacts on therapist or client outcomes. The current study aims to address this by exploring how psychotherapists develop competence through clinical supervision and what impact this has on the supervisees' practice and their clients' outcomes. This paper provides a rationale for the study and describes the protocol for an in-depth qualitative study of supervisory dyads, highlighting how it addresses gaps in the literature. Methods/Design: The study of 16-20 supervisor-supervisee dyads uses a qualitative mixed method design, with two phases. In phase one, supervisors who are nominated as expert by their peers are interviewed about their supervision practice. In phase two, supervisors record a supervision session with a consenting supervisee; interpersonal process recall interviews are conducted separately with supervisor and supervisee to reflect in depth on the teaching and learning processes occurring. All interviews will be transcribed, coded and analysed to identify the processes that build competence, using a modified form of Consensual Qualitative Research (CQR) strategies. Using a theory-building case study method, data from both phases of the study will be integrated to develop a model describing the processes that build competence and support wellbeing in practising psychotherapists, reflecting the accumulated wisdom of the expert supervisors. Discussion: The study addresses past study limitations by examining expert supervisors and their supervisory interactions, by reflecting on actual supervision sessions, and by using dyadic analysis of the supervisory pairs. The study findings will inform the development of future supervision training and practice and identify fruitful avenues for future research. [ABSTRACT FROM AUTHOR]

Background: Older women are at increasing risk of various forms of familial violence, yet detection is poor and very little is known of the long-term health effects of this psychosocial problem. The effectiveness of the 'Vulnerability to Abuse' Screening Scale (VASS) in predicting three year health outcomes was investigated among women enrolled in the Australian Longitudinal Study on Women's Health, now known as Women's Health Australia.Methods: The sample comprised a cohort of 10,421 women aged 73-78 who completed the 1996 and 1999 postal surveys (attrition rate 19.5%). The Time 2 sample had a small bias towards lower risk for elder abuse at Time 1 and better health on SF-36 and self-rated health. The VASS is a 12-item self-report measure with 4 factors: vulnerability, coercion, dependence and dejection.Results: Overall, physical health (PCS) declined while mental health (MCS) increased over the three year period. Decline in physical health was predicted by only the dejection factor, but not by factors which seem to more directly measure abuse. The predictive validity of the VASS for three year mental health outcomes was given partial support. Three of the four VASS factors (dejection, vulnerability, and coercion) predicted decline in mental health at the univariate level, however, after adjusting for confounders, only one VASS factor (dejection) independently predicted decline in mental health.Conclusions: While the VASS shows some promise as a marker of health risk in older women, only the dejection factor proved consistently predictive of declining health status. Further research is needed to determine longer term predictive validity of the scale and to gain a clearer picture of how abusive experiences impact on older women's health. [ABSTRACT FROM AUTHOR]