Healthcare professionals and expecting mothers frequently voice concerns that massages during pregnancy might cause complications or premature labor. This PRISMA review outlines current results on effects, side effects and contraindications of relaxation massage during pregnancy. Inclusion criteria: all randomized controlled trials (RCT) comparing relaxation massage during pregnancy with standard care or standard care plus another intervention (i.e., progressive muscle relaxation). Restrictions were full text availability and English language. Results: 12 RCT were included. Trials had good methodological quality but unknown risk of bias. All women were at least 12 weeks gestation at the start of the study. The main benefits of massage during pregnancy were: reduced stress, back and leg pain, depression and anxiety; increased immune response; increased serotonin and dopamine levels; higher fetal birth weight and reduced risk of preterm delivery. Only 2 RCT reported potential side effects of massage, which were minor and transient. Seven RCT excluded women with difficult pregnancies or preexisting complications, five studies did not report preexisting conditions. Those obstetric or postnatal complications that occurred were most likely unrelated to massage treatments. In healthy pregnant women without complications, relaxation massage has positive effects throughout pregnancy. Precautions for massage during pregnancy (i.e., to prevent pulmonary embolism) are discussed.

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The student experience is a unique journey of challenge and opportunity, for which their success, subjective well-being (SWB) and psychological health are key elements. In three related investigations, this mixed-methods research programme examined the effects of Time-Perspective (TP: An individual’s psychological relationship with time) and Character-Strengths (CS: 24-positive traits associated with good character) on these outcomes. Investigation 1 involved developing a Likert-type scale to measure students’ success in areas they felt were important to the construct. Qualitative content analysis identified that HE students and staff collectively defined success as a multifaceted construct, consisting of numerous academic, non-academic and social aspects. These informed the development of a reliable and valid questionnaire for measuring success perceptions in seven of these areas. This was used in the following investigation to assess a range of outcome variables pertaining to student success. Investigation 2 was a longitudinal study assessing the effects of TP and CS on the success, good/poor psychological health and SWB of Year-1 HE students. In line with previous research, excessive or insufficient use of certain TP orientations was associated with, and could predict multiple positive and negative outcomes. For example, Future and Past-Positive orientations were predictive of academic success, perceived student success and SWB. Student psychological problems were associated with a bias towards Past-Negative and Present-Fatalist orientations. Additionally, a new formula for calculating a continuous Balanced Time Perspective (BTP) variable was devised and tested. High levels of BTP were associated with many positive aspects of the HE experience. Strengths were mainly associated with SWB and perceptions of success. However, Hope and Self-Regulation were inversely related with depression, anxiety, stress and negative-affect. Investigation 3 was a follow-up interview study with six student participants, who presented interesting profiles in Investigation 2. They talked about their experiences of psychological ill-health/well-being and student success in relation to TP and CS. Five super-ordinate themes were identified, including ‘Living with negative past experiences’, ‘A balancing act’ and ‘Using my strengths’. Psychological difficulties represent an escalating problem in HE, and student success and SWB are important outcomes. Both TP and CS offer additional understandings of these areas, adding value in academic, practical and theoretical contexts. This research has indicated that interventions focused on TP modification (i.e. developing a BTP) and strength development, may potentially offer preventative mental-illness strategies for susceptible students and enhance their success and SWB.

The main objective of this thesis was to examine gender differences in co-rumination using observational, experimental, and diary methods. At the start of this project there were no existing studies which had assessed co-rumination in this way and this thesis intended to be an exploratory investigation of co-rumination using these methods. Rose (2002) defined co-rumination as ‘excessively discussing problems within a dyadic relationship’ (p. 1830) and used it to explain why females have closer, more supportive, friendships (Rose & Rudolph, 2006) but are also more susceptible to depression (Weissman & Klerman, 1977). Her findings suggest that co-rumination has maladaptive outcomes for females (increased depression and anxiety) but not for males. The six studies within this thesis aimed to investigate the outcomes of co-rumination using adult (Studies 1- 4), adolescent (Studies 5 and 6) and child samples (Study 6). The first three studies within this thesis assessed co-rumination using dyadic analyses of observational and experimental data. The results of these studies indicated that scores from the co-rumination questionnaire (CRQ) and the co-rumination coding scheme (CRCS) were associated with affect, but that the co-rumination manipulation used in Study 3 had no effect on levels of affect. CRCS was mainly predictive of depressive outcomes whereas CRQ was predictive of both depressive and anxious outcomes. The research indicated that CRQ scores positively correlated across the two dyad members. However, each dyad member’s score showed different associations with affect, depending on whether the dyad member was presenting his or her own problem for discussion. The diary studies indicated that co-rumination was best assessed using daily items which were more predictive of changes in positive and negative affect than the CRQ. It was clear from the studies within this thesis that co-rumination did not only have negative outcomes for females, and that future research should examine the outcomes of co-ruminative discussions for males and females. It was suggested that future researchers should conduct similar experimental research to Study 3 but that they should include multiple co-ruminative interactions and more immediate assessments of co-rumination in the days following a co-ruminative interaction.

Vitiligo is an idiopathic, non-contagious and often familial depigmentation disorder affecting both sexes equally. The mostly progressive and patchy loss of the inherited skin colour is not only a cosmetical problem, it has a profound impact on the patient's well-being. Stigmatisation and rejection often causes depression, self-consciousness, sexual problems and an impaired quality of life. To further substantiate earlier investigations and to introduce new aspects, we utilised the Dermatology Life Quality Index (DLQI), the Beck Depression Inventory (BDI) and the Adjustment to Chronic Skin Disorders Questionnaire (ACS) with its sub-scales on Social anxiety/avoidance, Helplessness and Anxious-depressive Mood in 422 patients and 55 healthy controls. We also included 103 children, their parents and 18 controls by using the Children's Dermatology Life Quality Index (CDLQI) and an adapted version of the ACS. We found that patients with vitiligo experience high levels of stigmatisation. They have an impaired quality of life and are more socially anxious/avoidant, helpless and (anxious-) depressive compared to healthy controls. The results correlate with disease severity, avoidant behaviour/hiding of vitiligo and the belief that psychological stress influences the disease. Female patients are generally more affected. Treatment with pseudocatalase PC-KUS improves quality of life and reduces anxious-depressive mood. Children also suffer from stigmatisation and an impaired quality of life. Parents are more socially anxious and helpless compared to the control group.

Many researches are focused on the study of depression in older age, their results show a negative impact of depression on the cognition of the elderly. There are not many studies that focus on geriatric anxiety and their results are often contradictory. In the theoretical part, this thesis aims to provide an insight into the anxiety from the philosophical and clinical standpoint, and in particular to describe the specifics of the geriatric anxiety and various areas of human life that may affect it. The practical part presents the results of 279 participants of the NANOK study aged 60-92 years, the analysis focuses on the effects of anxiety symptoms on cognition, taking into account depressive symptoms. Significant differences in healthy elderly persons are found only in the tests of immediate and delayed recall, no significant differences are found in the attention and executive functions tests. Various ways of influencing cognition by anxiety are discussed. In our sample of healthy older people, the rate of anxiety symtoms was not associated with the level of cognitive performance. Keywords: elderly; cognition; depression; anxiety; screening; Geriatric Anxiety Inventory; GAI

Background and aims: This interdisciplinary thesis was designed to deepen understanding of the co-morbidity of anxiety and depression with chronic diseases of the digestive tract, and inflammatory bowel disease (IBD) in particular. The first part of the thesis aimed to explore the prevalence of psychological problems in IBD compared to irritable bowel syndrome (IBS) and chronic hepatitis C (HCV) groups. It also explored the relationship between the number of co-morbid functional gastrointestinal disorders and the severity of psychological problems in IBD and IBS. It also aimed to determine whether there is a relationship between psychological problems and the response to standard medical treatment/physical outcomes in patients with IBD, IBS and HCV. Furthermore, it aimed to explore whether disclosure of the psychological status of depressed and/or anxious IBD patients to their gastroenterologists influences doctors’ behaviour and affects patients’ responses to treatment/physical outcomes. The second part of the thesis aimed to investigate the potential role of antidepressants in IBD and to determine the feasibility of future randomised controlled trials on the role of antidepressants in IBD. Methods: Overall, a cohort of 139 outpatients (64 IBD, 41 HCV, and 34 IBS) and 18 gastroenterologists participated in the six studies comprising this thesis. A mixed methods design was applied. Two cross-sectional studies, an observational cohort prospective management study, a randomised controlled trial, a systematic review and an exploratory interview study were conducted. Differences between the groups for continuous variables were assesed with one way analysis of variance (ANOVA) and independent samples ttests. Differences in categorical variables were assessed with contingency tables with the Chi-Square test and the Fisher’s Exact Test. Propsective analyses were conducted with repeated measures ANOVA, logistic regression and Poisson regression. Qualitative data were analysed using content analysis. Results: Overall, 42% of participants were anxious and 19% were depressed. Participants with HCV had higher levels of psychological impairment compared with the IBS, the IBD group and the general population (p<0.05). Those IBD participants with fewer co-morbid functional disorders had better physical quality of life than participants with a greater number of these disorders (p=0.025). Moreover, depression/anxiety at baseline did not explain medical outcomes after 12 months in this cohort of patients with chronic diseases of the digestive tract. Doctors’ knowledge of patients’ psychological status was found to have no impact on IBD patients’ outcomes after 12 months. However, interestingly, the level of anxiety in IBD participants significantly dropped between the baseline and nine months indicating a possible benefit from participating in the study. In the literature review, insufficient evidence was found to conclude that antidepressants are efficacious for treatment of psychological co-morbidities or somatic complaints in IBD. However, the qualitative interview study indicated a potential positive impact of treatment with antidepressants on coping with disease symptoms and general wellbeing in patients with IBD. Conclusion: The thesis confirms that there is a significant burden of psychological co-morbidity in patients with chronic gastroenterological diseases. Interdisciplinary approaches to the management of these diseases are therefore warranted in Australian gastroenterology clinics. Anxiety targeted interventions and research in this setting are urgently needed, especially with respect to patients with HCV. Larger studies exploring the gastroenterologists’ role in treatment of co-morbid psychological problems in their patients are recommended. Longer prospective studies on homogenous samples of patients are also needed to clarify the nature of the relationship between psychological problems and relapse of somatic symptoms. Finally, randomised controlled trials exploring the efficacy of antidepressants in IBD are warranted. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1321006 / Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008

The purpose of the present study was to prepare a Stress Management Program for the mothers of children with autism and to evaluate the effects of the program on depression, anxiety, and suicidal probability. It was hypothesized that the mothers of children with autism who attended the Stress Management Program would have lower depression, anxiety and suicidal probability whereas there would be no change in the depression, anxiety, and suicidal probability of mothers of children withautism who did not get any treatment. The participants of the study were 44 mothers of children with autism from Uyum Special Education Center and Ilgi Special Education Center. The data were gathered by administering four instruments / Beck Depression Inventory, Back Anxiety Inventory, Suicidal Probability Scale, and Demographic Information Form. Repeated Measures Analysis of Variance Technique was used to analyze the data. The findings of the study indicated that there was a significant decrease in depression levels of mothers of children with autism after the Stress Management Program whereas anxiety and suicidal probability did not change significantly as a function of the Stress Management Program. For the mothers of children with autism who did not get any treatment, it was indicated that there were no difference in depression, anxiety and suicidal probability. The results were discussed within the context of the relevant literature.

The aim of the present study was to investigate the moderator role of different types of social support (perceived vs. received) on the relationship between stress and health outcomes (depression, anxiety, and physical health) among the Turkish freshmen university students (with internal vs. external locus of control). In order to measure received social support, The Inventory of Socially Supportive Behaviors (ISSB) (Barrera, Sandler, &amp / Ramsay, 1981), was adapted into Turkish culture in Study 1 by using Middle East Technical University (METU) students from various departments. The sample of Study 2 consisted of 224 METU freshman students from several departments. Multiple hierarchical regression analyses were conducted with perceived/received social support and stress (frequency, intensity, general) as independent variables and depression, anxiety, and general physical health problems as dependent variables for internal locus of control and external locus of control students separately. The findings suggested that for both internals and externals, stress intensity, stress frequency, and general stress predicted depression, anxiety, and general physical health problems for both perceived and received social support. Different patterns of relationships were found among perceived/received social support, stress (frequency, intensity, general), and the outcome variables (depression, anxiety, general physical health problems) for internal locus of control and external locus of control students. The findings and strengths as well as the limitations of the study were discussed.

The present study aimed to reveal the effect of family functioning, attachment styles in romantic relationships, and city of origin on the emotional well-being of first year university students. 286 first-year university students from the Department of Basic English at Middle East Technical University participated in the study. They completed a demographic information sheet, the McMaster Family Assessment Device, the short-form Version of Experiences in Close Relationships Scale, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Hopelessness Scale. ANOVAs were run to find out if there are significant differences in the emotional well-being of participants with different cities of origin and gender. To assess if there are significant differences in the emotional well-being between participants with different attachment styles and cities of origin, ANCOVAs (Gender as the covariate factor) were conducted. Finally, regressions were run to find out the relationship between demographic variables, attachment styles, family functioning, and emotional well-being of first-year university students. The participants who moved to Ankara when they started university were found to report more depressive symptoms than the participants who had been living in Ankara. Further significant differences were observed in the depression and hopelessness levels of participants with different attachment styles. In general, those participants having fearful attachment styles tended to have more depressive symptoms and hopelessness as compared to those having secure and preoccupied attachment styles. Regression analyses revealed that absence of secure attachment style, fearful attachment style, and problems in affective responsiveness in the family were associated with symptoms of depression. Gender, fearful attachment style, and communication problems in the family were found to be associated with symptoms of anxiety / and fearful attachment style, communication problems in the family and inappropriate family roles were found to associate with hopelessness. These findings were discussed with reference to relevant literature. Future research topics were suggested and thereupatic implications of the study were stated.