Browsing by Author "Flett RA"

Now showing 1 - 20 of 23
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    Cannabis use and disorder transitions among a mixed community sample of at-risk adolescents and adults: A prospective New Zealand study
    (Bentham Open, 29/11/2013) Bashford J; Copeland J; Flett RA
    Introduction and Aims: The trajectories of cannabis use disorder (CUD) require more comprehensive delineation to expedite recognition of incubating dependence among high-risk users. This study examined baseline cannabis use and CUD over 12 months using DSM-IV/ICD10 diagnoses to distinguish transition groups. Design and Methods: In a prospective naturalistic design, 194 heterogeneous cannabis users (128 adolescents, 66 adults) aged 13-61 years were voluntarily recruited and assessed at baseline, and then re-assessed 12-months later. Results: Most participants met criteria for a baseline CUD (70% dependence, 20% abuse), 12 adolescents were 'diagnostic orphans', and 5 symptom-free. At follow-up, 25% adolescents reported using less, 6% the same level, and 69% using more cannabis. Significantly increased symptoms and dependence severity were reported, with no adolescent/adult differences evident. Three diagnostic transition groups were identified. While 84% adolescents (n=108) remained stable, 5% (n=7) had improved, 10% (n=13) had deteriorated. ‘Deteriorators’ scored significantly higher than ‘improvers’ on cannabis use, symptoms, and dependence severity measures. A subjective loss of control over cannabis use was among the earliest DSM-IV features among younger users on a trajectory towards dependence. Most participants (79%) anticipated difficulty trying to reduce/quit their use. Discussion and Conclusions: Younger adolescents can rapidly develop cannabis dependence, reporting similar and equally severe symptoms as longer-term adult users. Impaired control over use occurs early in trajectories towards dependence. The seeming intractability of problematic cannabis use calls for concerted cannabis screening and early intervention (SEI) efforts at an earlier age to avert or reduce harmful consequences of cannabis use in the community.
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    Considerations for culturally responsive Cognitive-Behavioural Therapy for Māori with depression
    (Cambridge University Press (CUP): STM Journals, 16/08/2016) Bennett ST; Flett RA; Babbage DR
    A strong case can be made for adapting cognitive-behavioural therapy (CBT) for ethnic and cultural minority groups. In North America, literature is readily available for CBT practitioners wishing to adapt their practice when working with ethnic minority groups (e.g., Latino, African-American, and Native American groups). In other countries such as New Zealand, literature of this sort is scarce, and the empirical foundation for CBT adaptation in these parts of the world is weak. This article documents the core tenets of an empirically validated CBT treatment protocol tailored for individual delivery to Māori clients suffering from depression in New Zealand and developed through consultation with an expert advisory group consisting of senior clinicians and Māori cultural experts. The result is a series of considerations for clinicians endeavouring to provide culturally responsive CBT with Māori clients, who are identified and organised into four domains. Two case studies are presented to illustrate the practical application of the proposed techniques. Links are made to international literature related to the adaptation of CBT in pursuit of cultural responsiveness.
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    Contribution of retirement-related variables to well-being in an older male sample
    (New Zealand Psychological Society, 2000) Alpass FM; Neville S; Flett RA
    With New Zealand's increasing older adult population comes an increase in the number of retirees. Changes in work patterns, earlier retirement and increasing life expectancy are resulting in longer periods of time spent in retirement. The effects of retirement on health and well-being have been viewed both positively and negatively and previous research on the impact of retirement has been equivocal. Inconsistencies may be attributable to a number of factors including time since retirement, changes in health status of the retiree, loss of social supports, policies of voluntary versus mandatory retirement and whether the work career was satisfying versus unfulfilled. Further, there are many possible outcomes following retirement and indices such as depression, and psychological well-being may be influenced by retirement in different ways. The present study sought to address a number of these issues by investigating the relative contribution of demographic, health, social support and retirement related variables to a number of indices of well-being in a group of retired older adult males. The present study found the nature of retirement (forced/voluntary) was unrelated to well-being outcomes; number of years retired was negatively associated with well-being outcomes; and prior job satisfaction was positively related to well-being outcomes. However, retirement variables contributed little to the overall explained variance in well-being indices. The major contributors to outcomes were diagnosis of a long-term illness or disability and satisfaction with social supports. Findings are discussed in relation to the literature.
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    Domestic violence, psychological distress, and physical illness among New Zealand women: Results from a community-based study
    (New Zealand Psychological Society, 2000) Kazantzis N; Flett RA; Long NR; MacDonald C; Millar M
    This study aimed to measure the prevalence of psychological distress and physical illness among women in New Zealand, and to identify the risk factors for psychological distress and health, with specific reference to domestic violence. A survey was carried out among a community sample of 961 women aged 19-90 years. Among all women surveyed, 25% were classified as experiencing psychological distress at the time of interview, 22% were classified as experiencing severe symptoms of physical illness, and 17% reported domestic violence by a family member at some point in their lives. Among those women who had experienced domestic violence, the perception that their life was in serious danger and the impact of the violence on their life each contributed significantly to variability in psychological distress (22% variance accounted). An estimated 12% of all cases of psychological distress and 7% of all cases of serious physical illness were attributable to domestic violence. The study underscores the need to improve policy for mental and physical health screening and care for abused women within health services in New Zealand.
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    Evaluating the content and quality of cognitive-behavioural therapy case conceptualisations
    (New Zealand Psychological Society, 2011) Haarhoff BA; Flett RA; Gibson KL
    Whilst case conceptualisation (CC) is considered a key Cognitive-Behaviour Therapy (CBT) competency, assessment and evaluation of the content and quality of CBT CC skills is not generally part of CBT training. In this paper, the content and quality of CCs produced by novice CBT clinicians was evaluated. Twenty-six novice CBT clinicians constructed CCs based on four clinical case vignettes. The content and quality of the CCs was evaluated using three rating scales, the Case Formulation Content Coding method, the Fothergill and Kuyken Quality of Cognitive-Therapy Case Formulation rating scale, and the CBT CC rating scale and benchmark conceptualisations. Descriptive statistical analysis of content displayed consistent distribution of subcategories of clinical information included, or omitted in the CCs. Underlying psychological mechanisms were emphasised. Information concerning biological, socio-cultural, protective factors, and the therapeutic relationship were generally omitted. As far as quality was concerned, between 50% - 61% of participants produced 'good-enough' CBT CCs. The consistent pattern of clinical information evidenced in the participants' CCs highlighted strengths and weaknesses which have implications for improving training in CC CBT competency.
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    Frequency of traumatic events, physical and psychological health among Maori
    (New Zealand Psychological Society, 2005) Hirini PR; Flett RA; Long NR; Millar M
    We examined the lifetime prevalence of 12 traumatic experiences (combat, child sex abuse, sexual abuse as an adult, family violence, other physical assault, theft by force, vehicle accident, other accident, natural disaster, disaster precautions, traumatic death (secondary trauma) and the links between these experiences and physical and mental health, via a cross sectional survey of 502 community dwelling New Zealand Maori adults. We found that the overall frequency with which such events occur in this group to be relatively high. Males were significantly more likely than females to report experience of combat, physical assault, theft by force, vehicle accident and other forms of accident. Females were significantly more likely to report sexual abuse as a child or adult, violence at the hands of a family member, and a traumatic death of a loved one. Younger respondents and those living in urban areas also reported more traumatic experiences of various sorts. There were some significant linkages between traumatic experiences and mental health (specifically PTSD, and the well-being scale of the MHI) but the size of the effects were small. We argue, that despite methodological limitations, these data are instructive about the frequency and impact of traumatic events among this group.
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    Gender and ethnicity differences in the prevalence of traumatic events: Evidence from a New Zealand community sample
    (John Wiley and Sons, Ltd, 2004) Flett RA; Kazantzis N; Long NR; MacDonald C; Millar M
    One thousand five hundred community residing New Zealand adults were assessed regarding their experience of traumatic events. Sixty-one per cent of those surveyed reported exposure to a traumatic event during their lifetime. Unexpected death of a close friend or relative was the most prevalent traumatic experience for the present sample, whereas combat and natural disasters were the least prevalent traumatic events. Consistent with prior research demonstrating gender differences in exposure to traumatic events, child and adult sexual assault was more common among women, and motor vehicle accidents and combat were more common among men. The present study also found that Maori individuals (indigenous people) had experienced a number of traumatic events to a greater extent than their European counterparts. These results are discussed within the New Zealand social context. Copyright © 2004 John Wiley & Sons, Ltd.
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    Influences on the stages and processes of exercise adoption in women
    (Australian Academic Press, 2006) Girling Butcher R; Towers AJ; Flett RA; Seebeck RF
    The present study investigated the transtheoretical model of behaviour change in relation to exercise adoption and maintenance in a sample of 140 women. The aim was to examine the relationship between the stages of exercise change, and the constructs of processes of change, costs and benefits of exercising, self-efficacy, and self-rated health. Analyses revealed that the processes, pros, cons, self-efficacy, and self-rated health were significantly associated with stage of exercise adoption. Specifically, the processes fluctuated, pros and self-efficacy increased, and cons decreased across the stages from precontemplation to maintenance. A stage exercise adoption perspective may be particularly useful for understanding how women adopt and sustain exercise regimes. © 2006, Cambridge University Press. All rights reserved.
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    Influential factors moderating academic enjoyment/motivation and psychological well-being for Maori university students at Massey University
    (New Zealand Psychological Society, 2005) Gavala JR; Flett RA
    Perceptions of stress and discomfort in the university environment and the relation between these perceptions and academic enjoyment/motivation and psychological well-being were examined in a sample of 122 Maori psychology students at Massey University. The moderating effects of perceived control and cultural identity were also considered. Major findings were that: (a) individuals reporting high stress, more feelings of discomfort at university, and a lower sense of academic control, were significantly more likely to be experiencing a lowered sense of well-being, and reduced feelings of academic enjoyment and motivation; (b) under conditions where there is a high sense of academic control, those with a high sense of comfort with university report significantly higher well-being that those with low comfort; (c) there were no moderating effects of cultural identity. Providing a comfortable academic environment that students' perceive as culturally-congruent increases perceived psychological well-being and academic enjoyment and motivation.
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    Motivation in humanitarian health workers: A self-determination theory perspective
    (Routledge, 2011) Tassell N; Flett RA
    This paper emerged from the authors' interest in why humanitarian health workers initially engage and remain in humanitarian work, often in the face of threats to safety and personal well-being. Semi-structured qualitative interviews assessed the consciously available reasons why individuals engaged in humanitarian health work. Interview data was unpacked through a thematic analysis. Using self-determination theory as a guiding framework, data suggested introjected and identified motivations are applicable to this occupational domain. Introjected motivation is implicated in initial reasons to engage the work, while identified motivation is implicated in reasons to continue. Theoretical and practical implications of these findings are discussed.
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    Obsessive passion as an explanation for burnout: An alternative theoretical perspective applied to humanitarian work
    (Australian Academic Press, 2007) Tassell NA; Flett RA
    Burnout is an occupationally based syndrome that develops as a result of prolonged and cumulative stress. The experience of burnout has been documented in detail in a variety of human service professions. The purpose of this article is two-fold: to provide an alternative theoretical perspective on the development of burnout, which suggests it is not stressors per se that are responsible for burnout development; and, to use this alternative perspective as an explanation for burnout in the context of another human service profession — humanitarian work. Using the passion for activities notion conceptualised by Vallerand and colleagues (2003), it is explained how a lack of self-determination and autonomy leads to the development of an obsessive passion for an activity. Obsessive passion is linked to a variety of adverse cognitive and affective outcomes. This is then applied to the domain of humanitarian work, and it is suggested individuals with an obsessive passion are more likely to suffer adverse outcomes and consequently develop burnout when working in humanitarian crises. Some suggestions for future theoretical and empirical investigations regarding the relationship between obsessive passion and burnout are provided. © 2007, Cambridge University Press. All rights reserved.
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    Predictors of health care utilisation in community dwelling New Zealand Māori
    (University of Papua New Guinea and Massey University School of Psychology, 2004) Flett RA; Hirini PR; Long NR; Millar M
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    Research ethics: A New Zealand perspective
    (3/07/2013) Flett RA
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    Stages of change for fruit and vegetable intake and dietary fat modification in Maori women: Some relationships with body attitudes and eating behaviours
    (New Zealand Psychological Society, 2005) Tassell NA; Flett RA
    We examined the influence of psychological factors (social physique anxiety, dietary self-efficacy), difficulties associated with making dietary changes and food security on stages of change for dietary fat reduction and increased fruit and vegetable intake in a non-probability convenience sample of New Zealand Maori women (N = 111) recruited through several acquaintanceship networks of the first author. We found that dietary fat intake, dietary self-efficacy and difficulties associated with changing fruit intake were significantly related to the stages of change for both dietary fat intake reduction and increased fruit and vegetable intake. In addition, difficulties associated with reducing dietary fat intake were significantly related to the stages of change for dietary fat intake reduction. As one moved along the change continuum, dietary fat intake and barriers associated with dietary change steadily reduced, whilst dietary self-efficacy increased. Sixty eight percent of the sample were categorised as either overweight or obese, and these participants reported significantly more anxiety and lower self-efficacy. Discussion focussed on the applicability of the study variables in the implementation of dietary related interventions for Maori women.
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    The changing nature of life regrets
    (18/11/2008) Towers AJ; Flett RA; Hill SR; Alpass FM
    IntroductionNew life stages promote new life goals and our most intense regrets should change in relation to our new goals and priorities.Research shows that 'Work' and 'Education' regrets are more common for older adults, who also tend to regret their inactions more than their actions. However, past research focuses in frequency and fails to indicate which regrets are actually more intense.We still don't know whether regret intensity changes with time and whether our most frequent regrets are also our most intense. Furthermore, we don't know whether regret-reducing processes, such as justification, are employed differentially across the life-span.
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    The decision appraisal model of regret
    (11/11/2005) Towers AJ; Flett RA; Hill SR
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    The impact of childhood sexual abuse on psychological distress among women in New Zealand.
    (2012-02) Flett RA; Kazantzis N; Long NR; MacDonald C; Millar M; Clark B; Edwards H; Petrik AM
    PROBLEMS: In order to better understand the long-term impact of child sex abuse, this study examined the association between women's experience of abuse, health symptoms, and psychological distress in adulthood. There is limited information about child abuse outside the United States. METHODS: Nine hundred sixty-one women participated in a structured interview. RESULTS: Participants who had experienced abuse (13%) were significantly more vulnerable to psychological distress in adulthood if they were younger, less satisfied with their standard of living, and resided in urban areas. CONCLUSION: Dissemination and evaluation of therapies for the treatment of sex abuse in the New Zealand context is warranted.
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    Traumatic events and physical health in a New Zealand community sample
    (International Society for Traumatic Stress Studies, 2002) Flett RA; Kazantzis N; Long NR; MacDonald C; Millar M
    Traumatic event exposure and physical health were examined in a community-residing sample of 1,500 New Zealand adults. Half (51%) reported past traumatic event exposure, 9% reported recent (past 12 months) trauma exposure, and 40% reported no exposure. After adjusting for gender, ethnic, and age differences, those experiencing crime and accident trauma exhibited significantly deteriorated physical health, as measured by current physical symptoms, chronic medical conditions, and chronic limitations in daily functioning. Further research is required to assess the influence of traumatic events on the physical health among adults from other countries, and to evaluate the factors that may mediate or moderate this relationship for different subgroups of the New Zealand population. Limitations of this study are outlined.