Saturday morning concurrent session #03

Tracks
Ballroom 3
Saturday, April 27, 2019
11:00 AM - 12:30 PM

Speaker

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Dr Amy Mullens
2019 Health Committee
USQ

Systematic literature review of fruit and vegetable consumption and obesity among Australian youth

11:00 AM - 11:10 AM

Abstract

This exploratory systematic literature review aims to investigate relationships between fruit and vegetable consumption (FVC), obesity, and socio-demographic determinants; and identify potentially modifiable factors, which may influence these relationships. FVC during early-life is recognised as an essential health behaviour with protective health effects.

Australian youth have extremely low adherence to dietary guidelines for FVC, which may affect their lifetime risk of obesity. Over 27.4% are overweight or obese increasing the risk of critical mental and physical health conditions (i.e., chronic depression; stroke) and early mortality. Evidence of socio determinants of health and potentially modifiable factors influencing relationships between FVC and obesity has not been systematically explored in an Australian context. This review aims to explore these relationships to understand which sub-groups may be most at-risk of low FVC and obesity; and identify crucial targets for future health promotion, and psychological intervention to change these trends.

PRISMA guidelines were followed. Searches were undertaken using nine databases (January 2013 to August 2018) across Australian settings. Inclusion criteria stipulated studies have to be peer-reviewed, in English, reporting data from Australia youth (aged 5-18) and relevant research questions examining relationships between FVC, obesity, socio-demographic determinants, and potentially modifiable factors. Nineteen articles met review inclusion criteria. Seven were high quality, 12 moderate, and no low quality studies.

Relationships were identified between low FVC, being overweight/obese, and some socio-demographic determinants which were affected by identified modifiable factors. Results identified at-risk sub-groups of the population, which will help inform future psychological interventions, research and health promotion efforts.

Biography

Jeni worked for eight years as a counsellor providing adults and children with help for chronic obesity, eating disorders and health related issues. In 2018, she completed her Bachelor of Science (Psychology) where she was supervised by Dr Amy Mullens, Health and Clinical Psychologist. She is now working towards her psychology registration.
Miss Tiffany Brooks
Neaves and Menne Clinical Psychology

Predictors of depression, anxiety and stress in a cohort of women with chronic pelvic pain

11:20 AM - 11:30 AM

Abstract

Objective: To identify predictors of depression, anxiety and stress in a cohort of women with Chronic Pelvic Pain (CPP).

Design: Cross-sectional analytic study.

Main Outcome Measures: Predictors were obtained from a private pelvic pain clinic initial assessment questionnaire. The outcome variables of depression, anxiety and stress were obtained from the Depression, Anxiety and Stress Scale 21-item (DASS21) subscale scores.

Results: Questionnaires were collected from 212 women with CPP over 18 months. Multivariate linear regression with backwards elimination was used to determine the best joint predictors of depression, anxiety and stress scores on the DASS21. Nineteen variables were identified as potential predictors. Higher depression scores were associated with higher current pain severity, a history of stabbing pains, prior experience of a sexually distressing event, having experienced pain as a child, and never having been pregnant before. Higher anxiety scores were associated with higher current pain severity, a history of stabbing pains, prior experience of a sexually distressing event, younger age of menarche, and younger age. Predictors of high stress scores were higher current pain severity, a history of stabbing pains, prior experience of a sexually distressing event, and being younger.

Conclusions: We have identified several important predictors of mental health in women with CPP. Using this information, psychological assessment and treatment for these women may be better tailored to client needs.

Biography

Miss Tiffany Brooks is a registered Health Psychologist at Neaves and Menne Clinical Psychology, who is also a PhD candidate at the University of South Australia. She has previously completed a Master of Psychology (Health) at the University of Adelaide and a Bachelor of Psychology (Hons) at the University of South Australia. She has previously completed an endorsement in health psychology and has obtained provider status for cognitive processing therapy. Clinically, she predominantly sees clients with concerns related to Post-Traumatic Stress Disorder, Anxiety, chronic health and Chronic Pain conditions. She is interested in research into the overlap between mental and physical health components. Her Honors, Masters and PhD research has centred around psychological aspects of Chronic Pelvic Pain in women.
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Ms Taryn Lores
CALHN, SA Health

Integrated psychological care is needed and welcomed by patients with Inflammatory Bowel Disease

11:30 AM - 11:40 AM

Abstract

Aim: To investigate the potential benefits of an integrated psychological care model in a hospital service for patients with Inflammatory Bowel Disease (IBD). Patients with IBD are at an increased risk of mental health issues but these are not routinely addressed in IBD care.

Design: Prospective, observational study design was used for its practicality and reflection of real-world care.

Method: Over a twelve-month period, 490 patients from an established hospital-based IBD service were approached to participate. Screening questionnaires and study information were sent to potential participants ahead of scheduled outpatient appointments, with patients followed-up in person. Screening questionnaires were the Hospital Anxiety and Depression Scale (HADS), Kessler 6 (K6), the Morisky Medication Adherence Scale (MMAS-8), and the Assessment of Quality of Life measure (AQoL-8D). Disease-specific, demographic and healthcare utilisation data were also collected via electronic records. Psychological support and intervention were offered to participants whose scores on screening measures indicated likely need. Participants were reassessed 12 months after initial intake.

Results: Psychological screening was well-accepted, with 68% of IBD patients approached participating (N=335). Mental health issues were prevalent with 55% of participants (N=183) scoring above clinical cut-off scores for anxiety, depression and/or general distress. Half of these “in need” participants (N=91) accepted the offer of psychological intervention. After 12 months follow-up, participants who accepted psychological intervention experienced improvements in their levels of anxiety (M1=12.11 vs M2=9.59, p<.001), depression (M1=8.38 vs M2=6.42, p<.001), general distress (M1=17.99 vs M2=13.96, p<.001), mental health quality of life (M1=54.64 vs M2=59.70, p<.001) and overall quality of life (M1=57.60 vs M2=64.10, p<.001) compared to intake. Engagement in psychological intervention was six times greater for those treated in-service versus those externally referred [X2(1)=13.06, p<.001, OR=6.47].

Conclusion: Mental health issues are prevalent in people with Inflammatory Bowel Disease, and there is a clear need to provide psychological support and intervention in care. IBD patients are open to having psychological screening and treatment integrated within a hospital service. Psychological care can improve patient mental health and quality of life, and works best when integrated into routine management.

Biography

Taryn is a health psychologist with the Inflammatory Bowel Disease Service at the Royal Adelaide Hospital in South Australia. She completed her Master of Psychology (Health) degree at the University of Adelaide in 2014, and her Bachelor of Psychology (Honours) degree at Flinders University in 2007. She has a strong interest in working with people with chronic health conditions to reduce disease burden and improve mental health. She has a special interest in the field of psychogastroenterology. Taryn has been with the IBD Service at the Royal Adelaide since September 2015, undertaking both clinical work and research. In addition, she works in private practice and at the South Australian Health and Medical Research Institute.
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Miss Samantha Ryan
Western Sydney University

Women's experiences of the body during the premenstrual phase of the cycle

11:40 AM - 11:50 AM

Abstract

Aim: Body dissatisfaction has been found to be associated with premenstrual distress, and is most prominent in the premenstrual phase of the cycle. However, the mechanisms influencing this relationship, and exploration of women’s construction and experience of their premenstrual bodies, remains little understood in Premenstrual Syndrome (PMS) research. Previous literature has established links between Reproductive Shame, Self-objectification and negative body image, however, there is no previous research regarding the association of these concepts with premenstrual change or PMS. The present study aimed to address these gaps

Design: A mixed-methods design was used to examine the way that women aged 18 to 55 who experience negative premenstrual change, construct and experience their premenstrual bodies.

Method: One-hundred and forty-nine participants completed an online survey utilising open and closed questions examining premenstrual change and the body, Premenstrual Distress, Body Dissatisfaction, Reproductive Shame and Self-objectification. These variables were analysed quantitatively, looking for association between variables, and open-ended data was used to screen for participants to participate in a follow-up semi-structured interview. Eight participants completed an interview, which along with open-ended survey data, was analysed through thematic analysis.

Results: Quantitative analysis indicated significant positive correlations between Premenstrual Distress, Body Dissatisfaction and Reproductive Shame. Self-objectification was significantly negatively correlated with Body Dissatisfaction. Regression analysis demonstrated that Body Dissatisfaction was a unique predictor of Premenstrual Distress. Qualitatively, women described negative experiences with their premenstrual bodies, associated with internalisation of unrealistic cultural constructions of feminine beauty, resulting in concealment of the body and reduced engagement in body-management behaviours.

Conclusion: The current study highlights the importance of understanding women’s experiences with their bodies, and the association this has with social constructions of the feminine body. Therefore, the complexity involved in women’s experiences with their bodies needs to be acknowledged in order to gain better insight into how to better interrupt women’s negative body image.

Biography

Samantha Ryan has recently completed a Bachelor of Psychology (honours) at Western Sydney University. She has completed an honours thesis under the supervision of Prof. Jane Ussher and Prof. Janette Perz at the Translational Health Research Institute regarding women's experiences of the body during the premenstrual phase of the cycle. Samantha has since received a positon as a PhD candidate at the Translational Research Health Institute and is furthering her research in women's experiences with the premenstrual body in the context of body dissatisfaction and body management behaviours.
Ms Jodie Brown

Psychological distress, body image and sexual dysfunction among individuals with lymphedema

11:50 AM - 12:00 PM

Abstract

Background: Lymphedema is an incurable, progressive and disfiguring disease, conservatively estimated to impact over 32,000 Australians (Lymphoedema Action Alliance, 2015). Among those vulnerable are cancer patients, with lymphedema affecting 36-47% of vulval, 24% of cervical, and 20% of breast cancer patients; and 9-29% of melanoma patients (Australian Government, 2018). Lymphedema involves accumulation of lymph fluid and significant swelling of affected areas. Serious physical complications include cellulitis, ulceration, and in extreme cases, septicaemia and death (Armer, 2009).

Aim: The purpose of this review was to explore psychological distress, body image and sexual dysfunction among individuals with primary or secondary lymphedema of the upper or lower limbs.

Method: PRISMA guidelines for systematic reviews were followed to identify studies for inclusion and analysis.

Results: The majority of studies examined women with secondary unilateral upper-limb lymphedema resulting from breast cancer, or lower- limb resulting from gynaecological cancer. A smaller number examined lymphedema resulting from filaria infection.
Most studies evaluated interventions for improving physical functioning and quality of life (QoL). QoL was defined generally or as synonymous with improved physical functioning. Few studies examined psychological functioning, self-image or sexuality. Interventions were generally viewed as ‘successful’ in that they improved physical functionality (e.g. reduced limb girth, increased flexibility). However, results were ambiguous regarding QoL, psychological functioning, self-image and sexuality. Few studies provided normative or healthy control group QoL comparisons.

Conclusions: Discrepancies between physical and psychological functioning may reflect gaps between medical and patient definitions of outcome. From a medical perspective, ‘slowing’ or ‘reduction’ of physical symptoms may be considered success. For patients, this may be outweighed by daily maintenance; restrictive garments; financial burden; disfigurement; problems with self-esteem, body-image and sexuality; fear of infection and limb deterioration; grief and loss; and pain. Further research into patient defined definitions of functioning are advised, particularly qualitative studies that can explore QoL within the context of individual daily living and idioms of distress, and longitudinal studies that track QoL and psychological functioning over time as the patient adjusts to changes in physical functioning. Psycho-therapeutic interventions that focus on self-image, grief and loss, acceptance, mindfulness and motivational interviewing may be beneficial.

Biography

Jodie Brown is a Clinical Psychology Registrar with over fifteen years experience working within the field of mental health across public and private, government and non-government settings, charity and for-profit organisations. She has worked across frontline and senior policy positions, as well as having extensive experience as a clinical educator in adult learning environments. Jodie has a special interest in working with vulnerable populations and in the prevention of suicide, as well as in bringing increased awareness to the experiences of carers and to the impact of traumatic stress on health and wellbeing for clients and carers alike. Jodie currently works within the headspace Youth Early Psychosis Program as a clinical educator specialising in trauma-informed practice, in private practice offering individual therapy, and as a casual academic at the University of Southern Queensland. Jodie has had work presented at international conferences and has a particular research interest within the field of trauma, both in the pathology of post-traumatic stress but also in the more healing aspects post-traumatic growth.
Ms Katharine Turner
Counselling and Psychology

Creating workplaces that enable health and wellbeing to flourish.

12:00 PM - 12:10 PM

Abstract

To explore the relevance of recent research to Health and Wellbeing in the organisational setting. The workshop will provide an opportunity to consider current thinking in light of practical experience, particularly in relation to large open plan workplaces.

Participants will have an opportunity to consider their own examples in the context of current research and under the broad headings of prevention, systematic protection and intervention.

Biography

Katharine began her Psychology career as a research assistant on a National Medical Health and Research grant in 1980. The journey has taken her through School Psychology with the Tasmanian Education Department, Staff Counselling at the Royal Hobart Hospital, Centrelink Psychology and Learning and Development with the Department of Human Services. These government positions have been supplemented with private practice along the way. Kathy has spent the last two years working as a Team Leader, drawing on all of these experiences to improve the workplace and assist her staff in improving their health and wellbeing. Kathy studied Psychology and Education at the University of Tasmania in the 1980s, upgrading to a Master of Business Administration Professional in 2014. Kathy has been a Member of the APS and now a Fellow of the Colleges of Health and Organisational Psychology. Kathy has one child at University and one completing their year 12.
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Ms Jenny Welsh

Taking a social determinants approach to mental health and health psychology: concepts, cases and practice

12:10 PM - 12:30 PM

Abstract

All health problems occur within a context. This workshop describes the social, economic and other influences that are shaping the lives of our clients and therefore their health. Our main focus will be on mental health and health behaviours, however a social determinants approach is relevant to almost all health problems. The workshop will introduce participants to the social determinants of health and the implications for policy and psychologists working a range of areas including hospitals and private practice. It will provide a theoretical overview of population based approaches to mental health, as well as an introduction to the social determinants of health paradigm.

We will discuss whether mental health, like other forms of health, is unequally distributed across society, and evidence on whether mental illness varies by age, gender, culture, socio-economic status and throughout history. We will discuss how important prevention behaviours (physical activity, healthy eating, sleep) are also shaped by social resources such as money, time and education. We will use case study examples to identify barriers in addressing social determinants of mental health and consider how these impact overall health status. Our aim is encourage participants to begin thinking about how their work can address these barriers.

Biography

Lyndall Strazdins Dr Strazdins is an Professor at the National Centre for Epidemiology and Population Health, and Director at the Research School of Population Health, the Australian National University. She is a recognised leader in the field of work, family and child wellbeing, especially the role played by the quality of parents’ jobs and the pressures and challanges on families to combine work with caring. She leads the work and family component of the Federally funded Longitudinal Study of Australian Children, a study of 10,000 families, and has or currently serves as a scientific consultant to Government, including the ACT Health Promotion Branch, the Department of Veteran Affairs Human Rights and Equal Opportunity Commission and the Defence forces and a consultant to the Paid Parental Leave Evaluation. She also collaborates with National NGO organisations regarding social policy for Australian families. In 2011 Strazdins was awarded an Australian Research Council Future Fellowship investigating time as a resource for health. Her research focuses on contemporary predicaments of work and care and their health and equity consequences, viewing health as inter-linked within families. More recently she has been developing theory on time as a social determinant of health and seeking to understand the significance of time as a resource, like money, which not only structures power relations and gender inequality but also peoples’ capacity to be healthy. Liana Leach Dr Leach is a research fellow in the Society, Culture and Health research stream at The National Centre for Epidemilology and Population Health (NCEPH). Her research interests include examining the impact of family and work circumstances on mental health. Her work involves the translation of mental health research for public policy and practice. Dr Leach completed an undergraduate Honours degree in Applied Psychology at The University of Canberra in 2003. Since this time, she has undertaken research projects with the Australian Demographic Social Research Institute (ADSRI) and the Centre for Mental Health Research (CMHR) at The Australian National University. Dr Leach completed her PhD at the CMHR titled 'Gender differences in depression and anxiety across the adult lifespan' in 2009. She has published her work in several high quality academic journals as well as national and international conferences. Jennifer Welsh Jenny Welsh is a PhD Candidate and Senior Research Officer and at the National Centre for Epidemiology and Population health with the Research School of Population Health. She is a quantitative researcher with interest in social epidemiology and large datasets, including the HILDA Survey and the 45 and Up Study. Prior to commencing her PhD, Jenny worked on a number of projects investigating the social influences of health, including projects on time scarcity, social capital, job quality and population ageing. Jenny’s PhD investigates the role of psychological distress in generating inequalities in cardio vascular disease.

Session Chair

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Kyra Hamilton
2019 Health Committee


Volunteer

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Danica Gregory
University of Adelaide

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Kate Obst
University of Adelaide

Andriana Tran
University of Adelaide

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