2013, Cosh, Suzanne, Maksimovic, Lauren, Ettridge, Kerry, Copley, David, Bowden, Jacqueline A

Smoking prevalence among Indigenous Australians far exceeds that of non-Indigenous Australians and is considered the greatest contributor to burden of disease for Indigenous Australians. The Quitline is a primary intervention for facilitating smoking cessation and, given the health implications of tobacco use, maximising its effectiveness for Indigenous Australians is imperative. However, the utilisation and effectiveness of this service within the Indigenous Australian population has not been examined. This study explores the utilisation of the South Australian Quitline by smokers identifying as Indigenous Australian. Quitline counsellors collected data regarding demographic characteristics, and smoking and quitting behaviour from Quitline callers in 2010. Results indicated that the proportion of Indigenous and non-Indigenous smokers who registered for the service was comparable. Demographic variables and smoking addiction at time of registration with the Quitline were similar for Indigenous and non-Indigenous callers. However, results indicated that Indigenous callers received significantly fewer callbacks than non-Indigenous callers and were significantly less likely to set a quit date. Significantly fewer Indigenous callers reported that they were still successfully quit at 3 months. Thus, Indigenous Australian callers may be less engaged with the Quitline and further research is required exploring whether the service could be tailored to make it more engaging for Indigenous Australians who smoke.

2023-11-10, Tully, Phillip J, Cosh, Suzanne M

This chapter elaborates on the treatment of depression and anxiety disorders simultaneously in patients with cardiovascular diseases (CVDs) using the Unified Protocol (UP). Persons with CVDs alongside depression or anxiety have a heightened risk for death and disability, poor quality of life, and significantly higher costs for medical care. The UP provides a coherent conceptual and pragmatic approach to treating emotional disorders that are highly prevalent in CVD populations. Anxiety disorders remain largely neglected by randomized control trials due to procedural challenges in applying traditional cognitive–behavioral therapy (CBT) exposure therapies to CVD patients. Thus, the UP delivers immense benefits and a novel approach to patients with CVDs and comorbid emotional disorders.

2019-08-14, Cosh, Suzanne, Helmer, Catherine, Delcourt, Cecile, Robins, Tamara G, Tully, Phillip J

Hearing loss (HL) is highly common in older adulthood, constituting the third most prevalent chronic health condition in this population. In addition to posing a substantial burden to disease and negatively impacting quality of life, an emerging literature highlights that HL is associated with unipolar depression including among older adults. This review outlines evidence examining the HL and depression relationship as well as clinical implications for assessment and treatment of comorbid depression and HL. Although prevalence estimates of comorbid depression in HL vary, as many as 1 in 5 experience clinically relevant depression symptoms. Both cross-sectional and longitudinal studies indicate that HL is related to increased unipolar depression symptoms, although the strength of the association varies between studies. A range of methodological variations, such as inclusion age, severity of HL and assessment of depression, likely underpin this heterogeneity. Overall, however, the evidence clearly points to an association of HL with clinically relevant depression symptoms. The association with the diagnosis of major depression disorder remains less clear and under-researched. HL is also associated with a range of other poor mental health outcomes in older adults, including anxiety and suicidal ideation, and predicts poorer cognitive functioning. Accordingly, assessment and treatment of comorbid depression in HL is pertinent to promote mental well-being among older adults. Currently, evidence regarding best practice for treating depression in HL remains scant. Preliminary evidence indicates that audiological rehabilitation, including use of hearing aids, as well as community-based hearing interventions can also improve mental health. Psychological intervention that enhances communication skills and addresses coping strategies might also be beneficial for this population. Additionally, evidence suggests that online interventions are feasible and may circumvent communication difficulties in therapy associated with HL. Due to poor help-seeking among this population, an enhanced focus on specific and targeted assessment and treatment is likely necessary to ensure reduced mental health burden among older adults with HL.

2014-03, Cosh, Suzanne, Tully, Phillip J

Objectives: Increasingly, athletes are expected to undertake tertiary education contemporaneously with their sporting careers. However, to do so may prove difficult and stressful. Exploration of the stressors encountered by student-athletes in combining the two pursuits is limited. There is also limited research examining whether combining the two pursuits impacts upon sporting or educational success. Design and method: A discursive psychological approach was employed, examining twenty interviews conducted with Australian athletes enrolled in tertiary education, exploring how athletes integrated sport and education. Results: Within the interviews, athletes constructed their primary academic goal as to ‘just pass’. Athletes repeatedly presented themselves as sacrificing educational success to integrate the two pursuits. Moreover, athletes constructed accounts of themselves as prioritising sport, but as passive in decision-making around priorities. In doing so, athletes produced accounts that removed their own agency for their sacrificed academic success. The interviewees also constructed time as a barrier to the successful integration of sport and education. In the dataset time was constructed either as fixed, limited and externally controlled, or as flexible and controllable. Conclusions: These alternate constructions allowed athletes to remove agency for poor educational outcomes, or conversely, enabled them to present themselves as successfully able to integrate sport and education. Thus, differing constructions of time were used to achieve different rhetorical ends. Implications and interventions for supporting student athletes successfully to combine sport and education are discussed.

2014-12, Tully, Phillip J, Cosh, Suzanne M, Baumeister, Harald

Objective: To (1) report the prognostic association between anxiety disorder subtypes and major adverse cardiac events (MACE), (2) report anxiety disorder prevalence in coronary heart disease (CHD), and (3) report the efficacy of anxiety disorder treatments in CHD. Methods: A comprehensive electronic database search was performed in November 2013 for studies reporting anxiety disorder prevalence according to structured interview in CHD samples or MACE, and randomized controlled trials (RCTs) comparing anxiety disorder treatment with placebo or usual care. From 4041 articles 42 samples were selected for extraction (8 for MACE prognosis, 39 for prevalence, no RCTs were eligible). Results: Five generalized anxiety disorder (GAD) studies reported 883 MACE events (combined n = 2851). There was a non-significant association between GAD and MACE (risk ratio = 1.20, 95% CI .86-1.68, P = .28) however the effect size was highly significant in outpatient samples (adjusted hazard ratio = 1.94, 95% CI 1.45-2.60, P < .001). No other anxiety disorder subtype was associated with MACE. Prevalence data showed high comorbidity with depression (49.06%; 95% CI 34.28-64.01) and substantial heterogeneity between studies. Panic disorder prevalence was higher in psychiatrist/psychologist raters (9.92% vs. 4.74%) as was GAD (18.45% vs. 13.01%). Panic and GAD estimates were also heterogeneous according to DSM-III-R versus DSM-IV taxonomies. Conclusions: The paucity of extant anxiety disorder RCTs, alongside MACE risk for GAD outpatients, should stimulate further anxiety disorder intervention in CHD populations. Research should focus on depression and anxiety, thereby unraveling disorder specific and more generic pathways.

2021-05-11, Tully, Phillip, Cosh, Suzanne, Wootton, Bethany

Hoarding disorder (HD) is characterized by an accumulation of possessions due to excessive acquisition of, or difficulty discarding possessions. Evidence demonstrates an increased cardiovascular response in patients with HD. Cognitive-behavioral therapy modifications are described for HD patients with heart failure to compensate for fatigability, syncope and falls risk.

2012, Hastie, Brianne, Cosh, Suzanne

Extensive work has been conducted on constructions of the female body as risky, particularly in relation to reproduction (Martin, 1987; Rich, 1976; Ussher, 2006). In contrast, the male reproductive body generally remains invisible (Oudshoorn, 2004). The analysis presented in this paper explores debate in 285 online responses to an article about gender-based differential pricing of health insurance. One of the discursive strategies drawn upon to defend this differential pricing is through familiar constructions of women's bodies as at risk' due to reproductive potential. However, this justification for inequality is resisted within the corpus through explicitly rendering the male body as similarly 'at risk' of reproduction. By examining how both women's and men's reproductive bodies are made visible, this paper explores discursive practices around how gender inequality is (re)produced and resisted. In particular, we can see how rendering the male reproductive body visible works in this context to resist practices that disadvantage women relative to men, and expand the responsibility for reproduction beyond women and individual, to society as a whole.

2012, Cosh, Suzanne, Crabb, Shona

Motherhood and participation in elite sport have traditionally been viewed as at odds with each other. However, mothers competing at the pinnacle of sport are becoming more common. Despite such trends, motherhood often remains invisible and taboo within the sphere of elite sport and little research has addressed athletes who are mothers. In order to explore popular accounts of motherhood and elite sport, we examined 326 media reports of the case of Keli Lane, an Australian water polo player who was convicted of murdering her infant in order to pursue her sporting goals. We draw on a social constructionist and critical approach to discursive analysis in order to explore repeated patterns of constructions of athlete identity and motherhood. We argue that within these media accounts, the identities of ‘elite athlete’ and ‘mother’ were depicted as mutually exclusive. Moreover, the role of the broader context of elite sporting culture and organisations in influencing the combination of motherhood and elite sport participation was rendered invisible within these accounts. The implications for female athletes, especially mothers, are discussed.

2024-06-04, Pike, Caitlin E, Dohnt, Henriette C, Tully, Phillip J, Bartik, Warren, Welton-Mitchell, Courtney, Murray, Clara V, Rice, Kylie, Cosh, Suzanne M, Lykins, Amy D

Background: Natural hazards are increasing in frequency and intensity due to climate change. Many of these natural disasters cannot be prevented; what may be reduced is the extent of the risk and negative impact on people and property. Research indicates that the 2019-2020 bushfires in Australia (also known as the “Black Summer Bushfires”) resulted in significant psychological distress among Australians both directly and indirectly exposed to the fires. Previous intervention research suggests that communities impacted by natural hazards (eg, earthquakes, hurricanes, and floods) can benefit from interventions that integrate mental health and social support components within disaster preparedness frameworks. Research suggests that disaster-affected communities often prefer the support of community leaders, local services, and preexisting relationships over external supports, highlighting that community-based interventions, where knowledge stays within the local community, are highly beneficial. The Community-Based Disaster Mental Health Intervention (CBDMHI) is an evidence-based approach that aims to increase disaster preparedness, resilience, social cohesion, and social support (disaster-related help-seeking), and decrease mental health symptoms, such as depression and anxiety.

Objective: This research aims to gain insight into rural Australian’s recovery needs post natural hazards, and to enhance community resilience in advance of future fires. Specifically, this research aims to adapt the CBDMHI for the rural Australian context and for bushfires and second, to assess the acceptability and feasibility of the adapted CBDMHI in a rural Australian community.

Methods: Phase 1 consists of qualitative interviews (individual or dyads) with members of the target bushfire-affected rural community. Analysis of these data will include identifying themes related to disaster preparedness, social cohesion, and mental health, which will inform the adaptation. An initial consultation phase is a key component of the adaptation process and, therefore, phase 2 will involve additional discussion with key stakeholders and members of the community to further guide adaptation of the CBDMHI to specific community needs, building on phase 1 inputs. Phase 3 includes identifying and training local community leaders in the adapted intervention. Following this, leaders will co-deliver the intervention. The acceptability and feasibility of the adapted CBDMHI within the community will be evaluated by questionnaires and semistructured interviews. Effectiveness will be evaluated by quantifying psychological distress, resilience, community cohesion, psychological preparedness, and help-seeking intentions.

Results: This study has received institutional review board approval and commenced phase 1 recruitment in October 2022.

Conclusions: The study will identify if the adapted CBDMHI is viable and acceptable within a village in the Northern Tablelands of New South Wales, Australia. These findings will inform future scale-up in the broader rural Australian context. If this intervention is well received, the CBDMHI may be valuable for future disaster recovery and preparedness efforts in rural Australia. These findings may inform future scale-up in the broader rural Australian context.

2017-09-01, Cosh, Suzanne, Zenter, Nadja, Ay, Esra-Sultan, Loos, Sabine, Slade, Mike, De Rosa, Corrado, Luciano, Mario, Berecz, Roland, Glaub, Theodora, Munk-Jorgensen, Povl, Bording, Malene Krogsgaard, Rossler, Wulf, Kawohl, Wolfram, Puschner, Bernd

Objective: The study explored relationships between preferences for and experiences of clinical decision making (CDM) with service use among persons with severe mental illness. Methods: Data from a prospective observational study in six European countries were examined. Associations of baseline staff-rated (N=213) and patient-rated (N=588) preferred and experienced decision making with service use were examined at baseline by using binomial regressions and at 12-month follow-up by using multilevel models. Results: A preference by patients and staff for active patient involvement in decision making, rather than shared or passive decision making, was associated with longer hospital admissions and higher costs at baseline and with increases in admissions over 12 months (p=.043). Low patient-rated satisfaction with an experienced clinical decision was also related to increased costs over the study period (p=.005). Conclusions: A preference for shared decision making may reduce health care costs by reducing inpatient admissions. Patient satisfaction with decisions was a predictor of costs, and clinicians should maximize patient satisfaction with CDM.