Copyright (c) 2012 All rights reserved. http://works.bepress.com/vicki_bitsika Recent documents in Vicki Bitsika en-us Sun, 07 Oct 2012 22:30:49 PDT 3600 http://works.bepress.com/vicki_bitsika/32 http://works.bepress.com/vicki_bitsika/32 Mon, 03 Sep 2012 21:25:46 PDT Depression is one of the major contributors to the Total Disease Burden and afflicts about one-sixth of Western populations. One of the most effective treatments for depression focuses upon analysis of causal chains in overt behaviour, but does not include brain-related phenomena as steps along these causal pathways. Recent research findings regarding the neurobiological concomitants of depressive behaviour suggest a sequence of structural and functional alterations to the brain which may also produce a beneficial outcome for the depressed individual--that of adaptive withdrawal from uncontrollable aversive stressors. Linking these brain-based explanations to models of observable contingencies for depressive behaviour can provide a comprehensive explanation of how depressive behaviour occurs and why it persists in many patients.

]]> Christopher F. Sharpley et al. http://works.bepress.com/vicki_bitsika/31 http://works.bepress.com/vicki_bitsika/31 Mon, 03 Sep 2012 21:25:45 PDT Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/30 http://works.bepress.com/vicki_bitsika/30 Mon, 03 Sep 2012 21:25:44 PDT As a preliminary investigation of the implications for counselling practice of Purpose in Life (PIL), Search for Neotic Goals (SONG) and Conscientiousness (CON) as potential buffers against anxiety and depression among university student clients, 398 students from a university in eastern Australia completed measures of these constructs. Results indicated that, although having a clear PIL and being conscientious were negatively associated with anxiety and depression, SONG was positively linked with these disorders. More importantly for counselling processes, up to 10% of those students whose anxiety and depression would make them most likely to seek counselling showed inverse relationships between PIL, SONG and CON and anxiety and depression. Several strategies are suggested for counsellors who work with university student populations.

]]> Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/29 http://works.bepress.com/vicki_bitsika/29 Mon, 03 Sep 2012 21:25:37 PDT Objective: To evaluate the literature supporting four potential criteria for deciding whether to use psychotherapy or pharmacology when treating depression.

Method: Literature review of the evidence from the last 10 years on presenting patient’s demographics, aetiology, comorbidity, and genetic factors, as predictors of treatment outcome efficacy.

Results: Demographic information has little support as a potential criteria for decision-making; aetiology (melancholic vs. non-melancholic) has significant support; presence of personality disorder comorbidity is unproven as a criterion but may have some value; genetic predisposition has the strongest evidence supporting it as a criteria for treatment decision-making.

Conclusion: Although some presenting cases will be easier to classify than others, there are substantial data supporting the screening of patients according to three of these criteria.

]]> Christopher F. Sharpley et al. http://works.bepress.com/vicki_bitsika/28 http://works.bepress.com/vicki_bitsika/28 Mon, 03 Sep 2012 21:25:36 PDT Some recent explanations of depression have suggested that it may be “evolutionary” in that there are advantages to the depressed individual which arise from some aspects of depressive symptomatology. While the depressive behaviour of withdrawal from the adverse environment may provide some immediate benefits to the depressed individual, thus making it potentially “adaptive” in the short-term, this does not fit the biological definition of “evolutionary”. In fact, depression does not meet two of the three required criteria from natural selection in order to be evolutionary. Therefore, while some depressive behaviour may be advantageous for the depressed individual, and is therefore “adaptive” in an immediate sense, it cannot be accurately described as “evolutionary”. Implications for research and clinical practice are discussed.

]]> Christoper F. Sharpley et al. http://works.bepress.com/vicki_bitsika/27 http://works.bepress.com/vicki_bitsika/27 Mon, 03 Sep 2012 21:25:35 PDT A 60-item scale of stressors that had been developed from interviews with 32 individual students was evaluated by administration to 402 students at an Australian university. As well as data that showed frequency of stressor occurrence to be a more powerful predictor of anxiety and depression than degree of discomfort that the stressor induced, psychometric data from this participant sample enabled refinement of the original scale by deleting several items, thus producing a 42-item scale for further investigation. Implications for use of the scale to identify the "causal" stressors which students experience and which lead to anxiety and depression, are discussed.

]]> Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/26 http://works.bepress.com/vicki_bitsika/26 Mon, 03 Sep 2012 21:25:34 PDT Background: The elevated anxiety and depression experienced by prostate cancer (PCa) patients can impair their decision-making as well as decrease their psychological well-being and weaken relationships with partner and family. Although standardised assessment models exist for identifying the symptoms of anxiety or depression, relatively little attention has been given to identifying the causal antecedents that PCa patients encounter and that may lead to anxiety or depression, nor their own attempts to cope with those antecedents. This study investigated the coping strategies used by a sample of PCa patients in response to the specific stressors and lifestyle changes that arose from their disease.

Methods: A total of 98 PCa patients responded to a survey about the kinds of disease-induced stressors they had encountered and the nature and success of any coping strategies they had used.

Results: The most common coping strategies reported were acceptance, exercise or activity, medication, having a positive attitude and seeking support from their wives or families. All strategies were classified as "active" responses to PCa-based stressors.

Conclusion: PCa patient anxiety and depression may be instigated by a range of stressors and patients' coping responses are also variable, with differing levels of success. From these data, a standardised inventory for assessing PCa patients' experiences of their illness and how they cope with those experiences is being developed, potentially contributing to the delivery of psychosocial therapies for PCa patients.

]]> Christopher F. Sharpley et al. http://works.bepress.com/vicki_bitsika/25 http://works.bepress.com/vicki_bitsika/25 Mon, 03 Sep 2012 21:25:33 PDT Introduction: Information given to breast cancer patients may not universally reduce anxiety and assist treament compliance. One possible reason could be that patient preferences for specific information sources may change over time.

Objectives: To compare breast cancer patients' preferred formats for receiving education about their disease and treatment soon after diagnosis versus about two years after that time.

Methods: An anonymous survey of 253 breast cancer patients' evaluations of alternative information formats was conducted within one month of diagnosis, and data were compared to those collected in a previous study from patients who were abut two years post-diagnosis.

Results: There were discrepancies between patients' ratings of, and preferences for, information format for preferences given by the present sample, as well as differences in patient preferences across the two studies (i.e., at different times post-diagnosis).

Discussion: Recency of diagnosis may have an effect upon patients' evaluations of information format, due to their memory limitations and elevated levels of anxiety and depression.

Conclusions: There is a need to tailor the format of information sources available to breast cancer patients according to time since diagnosis.

]]> Christopher F. Sharpley et al. http://works.bepress.com/vicki_bitsika/24 http://works.bepress.com/vicki_bitsika/24 Mon, 03 Sep 2012 21:25:31 PDT To determine the presence and nature of variability in anxiety and depression in patients with prostate cancer (PCa) over 3 years following diagnosis, 442 patients with PCa completed standardized anxiety and depression inventories via survey between 1 and 36 months after receiving their initial diagnosis. Data were analyzed from a series of 3-month cohorts, and results indicated that total scores and incidence of clinically significant anxiety and depression varied over time, but that this variability was restricted to specific subfactors of anxiety and depression. Provision of effective psychological treatment to patients with PCa is discussed.

]]> Christoper F. Sharpley et al. http://works.bepress.com/vicki_bitsika/23 http://works.bepress.com/vicki_bitsika/23 Mon, 03 Sep 2012 21:25:30 PDT Background: The aim of this study was to measure the incidence of anxiety-depression comorbidity among a sample of prostate cancer (PCa) patients and to investigate the total score, factor score and scale item differences across subgroups defined according to the presence of anxiety and/or depression.

Methods: 491 PCa patients who had received their initial diagnosis between 1 and 113 months previously completed a survey of background variables, as well as the Zung Self-Rating Anxiety and Depression Scales (SAS, SDS).

Results: Incidence of anxiety-depression comorbidity was nearly 16%, and higher than that previously reported in other samples. Although the directional differences of total anxiety and depression scores were as expected, analysis of underlying factor structures suggested significant overlap between anxiety and depression symptomatologies, and this was supported by analysis of scale item differences across disorder subgroups.

Conclusions: Comorbidity of anxiety and depression may be higher during treatment procedures and following treatment than has been previously suggested from data collected at the commencement of treatment for PCa. Diagnosis of anxiety or depression may benefit from consideration of symptoms that are more traditionally associated with the alternative disorder, thus potentially modifying treatment and support plans for PCa patients with these psychosocial disorders.

]]> Christoper F. Sharpley et al. http://works.bepress.com/vicki_bitsika/22 http://works.bepress.com/vicki_bitsika/22 Mon, 03 Sep 2012 21:25:29 PDT Anxiety and depression inventory scores from 200 male and female university students attending a private university in Australia were examined for their factor structure. Once established, the two sets of factors were tested for gender-based differences, revealing that females were more likely than males to report symptomatology associated with pain and fatigue, sleeping and digestive problems, psychomotor agitation, confusion, and pessimism. Implications for counsellors are discussed.

]]> Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/21 http://works.bepress.com/vicki_bitsika/21 Mon, 03 Sep 2012 21:25:28 PDT Background: Depression in breast cancer (BCa) patients can reduce quality of life, relationships and treatment compliance, thus constituting a major target for cognitive behavioural (CBT) interventions. Although CBT treatments, which are built upon consideration of the roles of antecedents and consequences for depressive behaviour, are effective, the nature of those antecedents which trigger depression among BCa patients has received relatively little attention.

Purpose: Hypotheses were (1) to determine if BCa patients were experiencing either or both of punishment type I and II and (2) to identify if these aspects of punishment were related to overall depression.

Method: Two hundred fifty-three BCa patients completed a standardised depression scale, and data were factor analysed. Components were interpreted for their relationship to punishment type I or II.

Results: Two major components emerged: (1) loss of previously available sources of personal or social reinforcement (i.e. punishment type II or negative punishment) and (2) behavioural, emotional and cognitive responses to those losses. These two components represent the total symptomatology of major depressive episode from DSM-IV-TR.

Conclusion: These findings support the application of a functional analytic model of depression within CBT assessment and treatment procedures with BCa patients.

]]> Christopher F. Sharpley et al. http://works.bepress.com/vicki_bitsika/20 http://works.bepress.com/vicki_bitsika/20 Mon, 03 Sep 2012 21:25:27 PDT Although several previous scales have been developed to measure the presence and effects of the stressful demands encountered by university students, most of these have been validated with samples drawn from US universities, commonly using only undergraduate psychology students. In addition, many of the items used are from scales designed for application within general adult populations, with little focus upon the specific stressors met by students. In order to identify what are the major changes these students encounter that they find stressful, a sample of 32 university students from different degree areas within an Australian university was individually interviewed using a standardised protocol. Results indicated that (unlike US data) these students found dislocation to family, friend and partner relationships most stressful, followed by the time demands of study and financial restrictions. Limitations of the study, future research directions and implications for counsellors are discussed.

]]> Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/19 http://works.bepress.com/vicki_bitsika/19 Mon, 03 Sep 2012 21:25:25 PDT Background: Although it is well established that prostate cancer (PCa) patients are more likely to experience clinical depression than their age-matched non-prostate cancer peers, and that such depression can have negative effects upon survival, little is known about the underlying nature of the depressive symptomatology that these men experience. In particular, the incidence of melancholic symptoms of depression, which are signs of increased risk of suicide and resistance to treatment, has not previously been reported in PCa patients. The present study aimed to measure the incidence and nature of Melancholia in PCa depression.

Method: A sample of 507 PCa patients in Queensland, Australia, completed anonymous and confidential questionnaires about their background, treatment status, and depression. Data were analysed to select depressive symptoms that were part of the definition of Melancholia vs those which were not. Regression was used to determine the links between Melancholia and overall depressive status, and factor analysis revealed the underlying components of Melancholia, which were mapped over time since diagnosis for 3 years.

Results: Psychometric data were satisfactory. Melancholia significantly predicted depressive status for the most depressed subset of patients, but not for the total sample. Melancholia was factored into its components of Anhedonia and Agitation, and the first of these was more powerful in predicting Melancholia. Variability over the 3 years following diagnosis was noted for each of these two components of Melancholia.

Conclusions: The strong presence of Melancholia in the depressive symptomatology of this sample of PCa patients suggests that some forms of treatment for depression may be more likely to succeed than others. The dominance of Anhedonia and Agitation over other symptoms of Melancholia also holds implications for treatment options when assisting these men to cope with their depression.

]]> Christopher F. Sharpley et al. http://works.bepress.com/vicki_bitsika/18 http://works.bepress.com/vicki_bitsika/18 Mon, 03 Sep 2012 21:25:24 PDT Sixteen breast cancer patients were interviewed about any lifestyle changes they had experienced and their reactions to those changes. Data were collected and analysed via content analysis and then summary tabulations of patient responses until replication of responses was verified across patients. Results indicated that most patients suffered a reduction in recreation activities, unpleasant physical side effects from treatment and loss of feminine appearance characteristics, all of which were seen as decreases in previously available and valuable sources of social support and self-esteem. In response to these losses, patients reported a common coping strategy of avoidance or escape similar to some depressive symptomatology. Implications for counsellors are discussed.

]]> Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/17 http://works.bepress.com/vicki_bitsika/17 Mon, 03 Sep 2012 21:25:23 PDT Aim: To explore the ways in which resilience is associated with anxiety and depression within a homogenous sample.

Methods: 401 Australian university students completed the Connor-Davidson Resilience Scale and the Zung Selfrating

Anxiety and Depression Scales. Factor scores from the resilience scale were regressed against total anxiety and depression scores, combined anxiety-depression scores and the underlying factors of the combined anxiety-depression construct.

Results: Self-confidence and optimism were most strongly negatively associated with anxiety and depression, followed by being decisive and solution-focussed and seeking challenges, having a strong purpose and being persistent, although different combinations of factors predicted anxiety than did depression. Spiritual beliefs did not appear to buffer against anxiety or depression in this sample.

Conclusion: Enhancement of resilience, self-confidence and optimism appear to be major potential targets for therapy intervention with this age and occupation group.

]]> Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/16 http://works.bepress.com/vicki_bitsika/16 Wed, 25 Aug 2010 18:14:46 PDT Although the detrimental effect upon psychological well-being of receiving a diagnosis of, or treatment for, cancer has been demonstrated across many different types of cancer, three recent reviews of the psychological health of prostate cancer patients have produced contradictory conclusions. In order to elucidate the reasons for these apparent different conclusions, each of these reviews is described, with principal methods and fi ndings summarised. Actual data, methodology used to select/reject research studies for inclusion in reviews, plus the validity of strict methodological culling of some research studies are discussed. Several extra studies and commentaries are also described, and a resolution of the apparent contradictory review conclusions is offered.

]]> Christopher F. Sharpley et al. http://works.bepress.com/vicki_bitsika/15 http://works.bepress.com/vicki_bitsika/15 Tue, 24 Aug 2010 22:46:45 PDT The experience of emotion underlies emotional expression and consequent action. Although several theoretical models of emotion have suggested that emotional expression is reciprocally involved with sensory inputs and behavioural responses to environmental stimuli, these discussions have largely focused upon fear and its survival value to the organism. By describing research studies across a wide range of emotions and the specific brain regions that are associated with those emotions, this review raises the hypothesis that the “form” of emotional experience neurogeography has followed the “function” associated with developing complex emotional and behavioural responses to challenging environmental stimuli. This separation of emotions within the brain thus confers a survival advantage for the organism in terms of reproduction, safety, and development of more effective problem-solving strategies.

]]> Christoper Francis Sharpley et al. http://works.bepress.com/vicki_bitsika/14 http://works.bepress.com/vicki_bitsika/14 Tue, 24 Aug 2010 22:46:44 PDT Traditional Functional Analytic procedures rely upon the identification of one or two 'target' behaviours for examination via observation and analysis. From these data, multiple functions are identified for each target behaviour via antecedent-behaviour-consequence data collection. However, although these methodologies have been shown to be effective with a wide range of inappropriate behaviours in classrooms, they have limitations when the inappropriate behaviours are so many and varied that selection of one or two as 'targets' becomes unreliable in terms of obtaining an accurate representation of the child's overall behavioural repertoire. A variation on this procedure is described and data from a case example are presented as a suggested alternative way of obtaining the kind of data required for effective classroom management of difficult behaviour.

]]> Vicki Bitsika et al. http://works.bepress.com/vicki_bitsika/13 http://works.bepress.com/vicki_bitsika/13 Tue, 24 Aug 2010 18:52:10 PDT The number of students who are labeled as having some form of behavioural disorder which requires specialized assistance in the regular school setting is growing. Current approaches to working with these students are often based on the standardized application of treatments designed to modify general symptoms rather than specific behaviours. It is noted that this approach to behaviour-change is limited because it does not seek to understand the reasons why particular behaviours are being used by students in particular settings. This paper will present an idiographic framework as an alternative approach to creating meaningful and long-term changes in the behavioural difficulties which occur in the school setting. This approach is based on developing a clear understanding of the purpose and usefulness of difficult student behaviour by investigating how that behaviour assists the student in gaining access to valued outcomes. Of particular significance to this assessment and intervention framework is the inclusion of the student's perceptions about the difficult behaviour and its impact on self, the environment and others. It is argued that effective changes in behaviour can only occur when the student's specific difficulties are understood and the student is taught specific skills to overcome these in the school setting.

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