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Marianna Szabó

The University of Sydney, Psychology, Faculty Member

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I'm a clinical psychologist and senior lecturer in psychology at the University of Sydney.
I have 15 years experience in mindfulness and other meditation practices, which are currently my primary research and clinical interests. I have a research backgound in developmental psychopathology and in psychological assessment, and maintain an interest in designing psychometrically sound measures and testing their adaptations in various cultures. A general interest in cross-cultural research also lead me to developing long-standing collaborations with colleagues in Hungary, with whom we are currently developing a culturally adapted Mindful Parenting program.
I speak fluent English and Hungarian, and very bad Italian.
Address: https://sydney.edu.au/science/people/marianna.szabo.php?apcode=ACADPROFILE300808

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Papers by Marianna Szabó

The Somatomorphic Matrix‐Female: More evidence for the validity of bidimensional figural rating scales for women

Journal of Clinical Psychology, Aug 24, 2022

Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic... more Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic Matrix-Female (SM-F), a new bidimensional female figural rating scale which can be used to gauge actual and desired levels of both body fat and muscularity in a consolidated measure, as well as providing an index of actual-desired body discrepancy based on these measures. Across two studies undergraduate women (n Study 1 = 481; n Study 2 = 391) completed the Eating Disorder Examination-Questionnaire, the Body Shape Questionnaire-34, and the Depression Anxiety Stress Scales-21 (Study 1) and the Drive for Thinness Scale and the Drive for Muscularity Scale (Study 2), as well as the SM-F. Overall, the SM-F demonstrated sound content, concurrent, and convergent validity for actual and desired body fat, actual and desired muscularity, and their respective discrepancy scores.

The Interpersonal Mindfulness in Parenting Scale in Mothers of Children and Infants: Factor Structure and Associations With Child Internalizing Problems

Frontiers in Psychology, Feb 3, 2021

Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP)... more Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP), is beneficial for parents and children. However, the IMP has not been validated in English-speaking parents. Further, little is known about whether mindful parenting is similar in parents of children vs. infants, or how it reduces child internalizing problems. We sought to validate the IMP in English-speaking mothers of children and infants, and to examine relationships between the facets of mindful parenting, child internalizing problems and parent variables related to internalizing. Methods: Using confirmatory factor analyses, we examined the fit of various models of mindful parenting in English-speaking community-recruited mothers of children aged 3-18 years (n = 396) and infants aged 0-2 years (n = 320). We used regression analyses to investigate relationships between the facets of mindful parenting, child internalizing problems, and parent variables including parental experiential avoidance, unhelpful beliefs about child anxiety and accommodation of child anxiety. Results: Mindful parenting can be measured in English-speaking mothers, using either a 5-or 6-factor, 29-item version of the IMP. These versions of the IMP operate similarly for mothers of children and infants. Child internalizing problems and related parent variables were best predicted by non-judgmental acceptance of parenting in mothers of children, and emotional self-awareness and non-reactivity in mothers of infants. Conclusions: The IMP is a valid measure of mindful parenting in English-speaking mothers of children and infants. Mindful parenting predicts child internalizing problems and related parent variables, suggesting that mindful parenting programs could benefit families of children with internalizing problems, potentially by reducing parental experiential avoidance, unhelpful beliefs about or accommodation of child anxiety.

Development and Psychometric Properties of the DASS-Youth (DASS-Y): An Extension of the Depression Anxiety Stress Scales (DASS) to Adolescents and Children

Frontiers in Psychology

The Depression Anxiety Stress Scales (DASS; Lovibond and Lovibond, 1995b) is a set of psychometri... more The Depression Anxiety Stress Scales (DASS; Lovibond and Lovibond, 1995b) is a set of psychometrically sound scales that is widely used to assess negative emotional states in adults. In this project, we developed the Depression Anxiety Stress Scales for Youth (DASS-Y) and tested its psychometric properties. Data were collected from 2,121 Australian children and adolescents aged 7–18 (61% female). This sample was split randomly into a calibration group (n = 1075, 61% female) and a cross-validation group (n = 1046, 60% female). First, we used Confirmatory Factor Analysis on the calibration group to test the 3-factor DASS model on 40 items we had developed in previous exploratory studies. We then selected the best-performing 21 items based on both statistical and theoretical considerations, guided by the structure and item content of the adult DASS. We cross-validated this new 21-item model in the second half of the sample. Results indicated good fit for the final 21-item 3-factor DASS...

Physical Social Outomes - Probability and Cost Questionnaires from Szabo 2009

Preventing suicide

The British Journal of Psychiatry, 2003

Alcohol Use by Australian Actors and Performing Artists: A Preliminary Examination from the Australian Actors’ Wellbeing Study

Medical Problems of Performing Artists, Jun 1, 2020

BACKGROUND: Anecdotal and media reports suggest that actors and performing artists are vulnerable... more BACKGROUND: Anecdotal and media reports suggest that actors and performing artists are vulnerable to high levels of alcohol use. However, little empirical research is available to document the extent and correlates of alcohol use amongst these artists, particularly in an Australian context. OBJECTIVE: This study investigated alcohol use in a sample of Australian actors and other performing artists and its associations with sociodemographic background, psychological wellbeing, and work stress. METHODS: An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists. The survey included questions on sociodemographic and occupational background and psychological wellbeing (DASS-21), as well as the AUDIT questionnaire to assess self-reported alcohol consumption. A sample of 620 performing artists responded to the survey, a large majority of whom were actors. RESULTS: Australian actors and performing artists appear to consume alcohol at levels that are higher than those found in the general Australian population. About 40% of men and 31% of women were classified as drinking alcohol at potentially harmful or hazardous levels. Alcohol use was not strongly associated with age, education, or income, but it had a relationship with poorer psychological wellbeing. About 50% of respondents reported that their alcohol drinking was related to work stress as a performer. This perception was more pronounced amongst those performers who reported drinking at harmful levels. CONCLUSIONS: Australian actors and performing artists appear to be an at-risk population for harmful or hazardous alcohol use.

A randomized controlled trial of a web-based mindfulness programme for people with MS with and without a history of recurrent depression

Multiple Sclerosis Journal, Feb 7, 2022

Background: Evidence shows small positive effects associated with psychological treatments for pe... more Background: Evidence shows small positive effects associated with psychological treatments for people with multiple sclerosis (PwMS). In a recent meta-analysis, the treatment with the largest effect size was a mindfulness-based intervention (MBI). Objectives: We aimed to determine whether an Internet-delivered MBI was beneficial for PwMS. Furthermore, we aimed to investigate history of recurrent depression as a moderator of treatment outcome. Methods: Participants ( N = 132) were assessed based on whether they had a history of recurrent depression, then stratified and randomized to MBI or waitlist. Outcomes were assessed at baseline, post-intervention, and 3 and 6 months. Results: The MBI group reported significantly improved depressive symptoms (primary outcome) compared with the waitlist ( p = 0.046, Cohen’s d = 0.39). Those with a history of recurrent depression benefitted significantly more than those without ( p = 0.034, d = 0.66). There were benefits for health-related quality of life (HRQoL) in the MBI, irrespective of depression history ( p = 0.009, d = 0.5). Pain interference was less overall in the MBI group ( p &lt; 0.001, d = 0.2), but change over time did not differ from waitlist. There were no treatment effects for anxiety, pain severity or fatigue. Conclusion: The Internet-delivered MBI significantly improved depressive symptoms and HRQoL in PwMS. For depression, the benefits were greater for those with a history of recurrent depression. Trial Registration: ACTRN12618001260213, available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375598

The evaluation of an online mindfulness program for people with multiple sclerosis: study protocol

BMC Neurology, Jun 14, 2019

Background: Multiple sclerosis (MS) is a neurological disease of the central nervous system and i... more Background: Multiple sclerosis (MS) is a neurological disease of the central nervous system and is associated with many psychosocial symptoms that are difficult to manage including low mood, anxiety, fatigue and pain, as well as low health-related quality of life. Internet-based psychosocial interventions that use mindfulness-based approaches are gathering much attention in recent literature, particularly in the treatment of chronic illnesses. However, no large randomized controlled trials have been done examining the efficacy of such interventions for people with MS (PwMS). Methods/design: This study is a randomised controlled trial of an online mindfulness-based intervention (MBI) for PwMS. Participants will be randomised to receive either the MBI or offered the intervention after a waiting period. All participants will be assessed to determine whether they have a history of recurrent depressive disorder. The primary outcome will be severity of depression, according to the Centre of Epidemiology Depression Scale. Secondary outcomes will be anxiety severity, fatigue, pain and quality of life. Assessments will be conducted pre, post-treatment, at three and six-month follow-up. The online mindfulness-based program was developed in collaboration with end-users (n = 19 PwMS) who gave feedback about what would be feasible and acceptable, and the draft program was reviewed by both experts and patients. Discussion: Multiple sclerosis is the most common acquired chronic neurological disease amongst young adults and is associated with a range of symptoms that can be difficult to cope with. In face-to-face interventions, a MBI demonstrated the largest effect in a recent meta-analysis of psychological treatments for PwMS, but MBIs for PwMS have not been delivered online. Hence, this trial will confirm whether MBIs can be efficacious when delivered online. A range of symptoms are assessed as outcomes so that the nature of benefits associated with the online MBI can be ascertained. Trial registration: ACTRN12618001260213.

The Australian Actors' Wellbeing Study: A Preliminary Report

About Performance, 2015

Eating Disorder Symptoms in Australian Actors and Performing Artists

Medical Problems of Performing Artists, Dec 1, 2019

AIMS: Anecdotal evidence suggests that actors and other performing artists are under great pressu... more AIMS: Anecdotal evidence suggests that actors and other performing artists are under great pressure to conform to idealized appearances and body types. The pursuit of such appearances may trigger eating disorder symptoms, such as unhealthy attitudes towards body weight and shape. Thus far, there has been no dedicated empirical study of the prevalence of such problems in Australian actors and performing artists specifically. Therefore, this study sought to examine eating disorder symptomatology in Australian actors and performing artists. METHODS: An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists, of whom 573 individuals completed the survey. This survey gauged demographic information and eating disorder symptoms using the psychometrically validated Eating Disorder Diagnostic Scale (EDDS). RESULTS: A large proportion of actors reported unhealthy attitudes such as ‘feeling fat’ even though they are of normal weight or underweight; reported an extreme fear of gaining weight; and evaluated their self-worth based on their body weight and shape, particularly women. Results also showed that 2.5% of women in the study met the diagnostic criteria for anorexia nervosa and 13% met diagnostic criteria for bulimia nervosa based on their scores on the EDDS. DISCUSSION: Performers may be a particularly at-risk population for the development and/or maintenance for a range of eating disorders.

Different Characteristics of the Female Sexual Function Index in a Sample of Sexually Active and Inactive Women

The Journal of Sexual Medicine, Sep 1, 2017

Background: The Female Sexual Function Index (FSFI) is a widely used measurement tool to assess f... more Background: The Female Sexual Function Index (FSFI) is a widely used measurement tool to assess female sexual function along the six dimensions of desire, arousal, lubrication, orgasm, satisfaction, and pain. However, the structure of the questionnaire is not clear, and several studies have found high correlations among the dimensions, indicating that a common underlying "sexual function" factor might be present. Aim: To investigate whether female sexual function is best understood as a multidimensional construct or, alternatively, whether a common underlying factor explains most of the variance in FSFI scores, and to investigate the possible effect of the common practice of including sexually inactive women in studies using the FSFI. Methods: The sample consisted of 508 women: 202 university students, 177 patients with endometriosis, and 129 patients with polycystic ovary syndrome. Participants completed the FSFI, and confirmatory factor analyses were used to test the underlying structure of this instrument in the total sample and in samples including sexually active women only. Outcomes: The FSFI is a multidimensional self-report questionnaire composed of 19 items. Results: Strong positive correlations were found among five of the six original factors on the FSFI. Confirmatory factor analyses showed that in the total sample items loaded mainly on the general sexual function factor and very little variance was explained by the specific factors. However, when only sexually active women were included in the analyses, a clear factor structure emerged, with items loading on their six specific factors, and most of the variance in FSFI scores was explained by the specific factors, rather than the general factor. University students reported higher scores, indicating better functioning compared with the patient samples. Clinical Translation: The reliable and valid assessment of female sexual function can contribute to better understanding, prevention, and treatment of different sexual difficulties and dysfunctions. Strengths and Limitations: This study provides a rigorous statistical test of the structure of the FSFI and an explicit decision rule for categorizing sexually inactive women. Limitations include a lack of control over the circumstances of data collection. Conclusion: This study supports the use of the FSFI as a multidimensional measurement of female sexual function but highlights the need to establish clear decision rules for the inclusion or exclusion of sexually active and inactive respondents. Hevesi K, Mészáros V, Kövi Z, et al. Different Characteristics of the Female Sexual Function Index in a Sample of Sexually Active and Inactive Women.

The Bifactor Model of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS)-An Alternative Measurement Model of Burnout

Stress and Health, Jan 24, 2013

The purpose of the present study was to examine the construct validity of the Hungarian language ... more The purpose of the present study was to examine the construct validity of the Hungarian language version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). A sample of 653 healthcare professionals (420 physicians and 233 nurses and nursing assistants) completed the MBI-HSS. A series of confirmatory factor analyses showed that a hierarchical bifactor model including a global burnout factor and three specific factors of emotional exhaustion, depersonalization and reduced personal accomplishment had the closest fit to the data, compared with an alternative second-order three-factor hierarchical model as well as to non-hierarchical one-factor, two-factor, three-factor, four-factor and five-factor models. However, only the global burnout factor and the specific personal accomplishment factor explained a considerable unique proportion of variance in observed scores. Our study confirms the validity of the MBI-HSS and suggests an alternative structural model, which may contribute to further understanding of the burnout construct.

Psychological Well-Being of Australian Actors and Performing Artists: Life Satisfaction and Negative Affect

Medical Problems of Performing Artists, Jun 1, 2022

BACKGROUND: Anecdotal evidence and media reports suggest that actors and other performing artists... more BACKGROUND: Anecdotal evidence and media reports suggest that actors and other performing artists experience high levels of depression, anxiety, and stress. However, no empirical study has examined the psychological well-being of this professional group. OBJECTIVE: The Australian Actors’ Wellbeing Study (AWS) was conducted to examine the general wellbeing of Australian actors and performing artists. The present paper, reporting on data from the AWS, focuses on two aspects of respondents’ psychological well-being: life satisfaction and the experience of negative affect. METHODS: An online survey including several questionnaires was distributed to the Equity Foundation membership representing Australian actors. We report results from the Satisfaction with Life Scale (SWLS) and the Depression Anxiety Stress Scales (DASS) and examine their associations with respondents’ sociodemographic and occupational background, including their relationship status and any relationship stress, income from performing, and time taken away from performing. RESULTS: A sample of 782 Australian actors responded to the survey, with 582 participants completing the DASS and 568 the SWLS. Participants reported lower levels of life satisfaction and higher levels of depression, anxiety, and stress than found in the Australian general population. Being in a relationship was associated with better psychological well-being; however, work stress often impacted negatively on relationships. Income had little association with psychological well-being, unless the respondent felt under financial stress. Respondents who took extended periods of time away from performing reported less life satisfaction and more depression than others. CONCLUSION: Australian actors may be at a high risk for poor psychological health. Further research is necessary to establish causality among the variables we examined and to investigate protective factors that may increase well-being in the context of the performing arts industry.

Development of a Web-Based Mindfulness Program for People With Multiple Sclerosis: Qualitative Co-Design Study

Journal of Medical Internet Research, Mar 2, 2021

Background: Mindfulness-based stress reduction is an efficacious treatment for people with chroni... more Background: Mindfulness-based stress reduction is an efficacious treatment for people with chronic health problems; however, it is highly intensive and time-consuming, which is a barrier for service provision. Objective: This study aims to develop an internet-delivered adapted version of mindfulness-based stress reduction for people with multiple sclerosis to make the intervention more accessible. Methods: We co-designed a web-based mindfulness program with end users, that is, people with multiple sclerosis (N=19). Iterative feedback was also collected from a subsample of the initial group of end users (n=11), and the program was reviewed by experts (n=8). Results: We identified three main themes common to people with multiple sclerosis: dealing with uncertainty and fears for the future, grief and loss, and social isolation. These themes were incorporated into narratives throughout the program. People with multiple sclerosis who reviewed the program gave feedback that the program was relatable, feasible, and acceptable. Experts agreed that the program appropriately represented the main tenets of mindfulness. Iterative feedback was used to further refine the program. Conclusions: The web-based mindfulness program that we developed was viewed positively by both experts and end users. The program reflects common concerns for people with multiple sclerosis and has the potential to meet important unmet psychological needs. A randomized controlled trial was planned to determine the efficacy of the program.

Randomised controlled trial of cognitive behaviour therapy versus mindfulness for people with rheumatoid arthritis with and without a history of recurrent depression: study protocol and design

BMJ Open, May 1, 2022

, et al. Randomised controlled trial of cognitive behaviour therapy versus mindfulness for people... more

Interpersonal Mindfulness in Parenting Scale--English Expanded Version

PsycTESTS Dataset

Mindful parenting is the extension of intra-personal mindfulness to inter-personal processes by d... more Mindful parenting is the extension of intra-personal mindfulness to inter-personal processes by developing and fostering mindfulness during interactions with a child when acting in the role of a parent. While some empirical evidence points to various benefits of mindful parenting both for the parent and the child, suitable measurement tools for mindful parenting are still being developed, especially for use in non-Western countries such as Korea. The present study involved development of a Korean version of the Interpersonal Mindfulness in Parenting (IM-P) scale using a large sample of Korean parents (n = 554) recruited online and a second, replication sample of Korean parents with children attending kindergarten (n = 283). Using an iterative approach of exploratory and confirmatory factor analysis guided by conceptual criteria, an 18-item Korean version of the instrument (IM-P-K) met psychometric criteria of classical test theory. Rasch analysis confirmed internal validity of this solution and also produced algorithms to convert the total ordinal-level summary scores to interval-level data. While the reliability of the six individual three-item subscales was only marginally acceptable, the reliability of the total interval-transformed score was excellent. The IM-P-K total scores correlated in expected directions with various other psychological constructs known to be associated with mindfulness, such as self-compassion, depression, psychological well-being, and perceived stress. This 18-item IM-P-K thus offers a suitable self-report instrument to investigate mindful parenting in Korean samples.

The precarious lives of actors

Australasian Drama Studies, Apr 1, 2018

This article investigates the precarious lives of working actors, drawing upon responses to the 2... more This article investigates the precarious lives of working actors, drawing upon responses to the 2012 Actors' Wellbeing Survey, to show how reliant actors are upon highly casualised work to supplement earnings from acting. The precarity of actors' lives manifests in a range of challenges, including, in addition to and partially as a result of, financial hardship, stress on relationships and senses of self-worth.

The Interpersonal Mindfulness in Parenting Scale in Mothers of Children and Infants: Factor Structure and Associations With Child Internalizing Problems

Frontiers in Psychology, 2021

Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP)... more Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP), is beneficial for parents and children. However, the IMP has not been validated in English-speaking parents. Further, little is known about whether mindful parenting is similar in parents of children vs. infants, or how it reduces child internalizing problems. We sought to validate the IMP in English-speaking mothers of children and infants, and to examine relationships between the facets of mindful parenting, child internalizing problems and parent variables related to internalizing.Methods: Using confirmatory factor analyses, we examined the fit of various models of mindful parenting in English-speaking community-recruited mothers of children aged 3–18 years (n = 396) and infants aged 0–2 years (n = 320). We used regression analyses to investigate relationships between the facets of mindful parenting, child internalizing problems, and parent variables including parental experiential ...

Improving children’s eating patterns: intervention programs and underlying principles

Eating patterns affect long-term health. Although dietary guidelines now recommend an increase in... more Eating patterns affect long-term health. Although dietary guidelines now recommend an increase in the consumption of fruit and vegetables and a reduction in daily energy intake derived from sugars and fats, evidence shows that in Australia, the UK and the USA children’s diets are widely discrepant from that which is thought to be desirable for good health. This article briefly describes the theoretical models underlying dietary interventions, especially those with children. The paper then outlines the major interventions from the published literature that have aimed to improve children’s eating patterns, and reflects on their efficacy primarily within the context of existing knowledge about the factors thought to influence children’s food choices and their health behaviour generally. The paper concludes by considering some of the methodological issues that are important in designing and establishing the efficacy of dietary interventions for children.

Preventing major depression in young people

British Journal of Psychiatry, 2002

The Somatomorphic Matrix‐Female: More evidence for the validity of bidimensional figural rating scales for women

Journal of Clinical Psychology, Aug 24, 2022

Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic... more Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic Matrix-Female (SM-F), a new bidimensional female figural rating scale which can be used to gauge actual and desired levels of both body fat and muscularity in a consolidated measure, as well as providing an index of actual-desired body discrepancy based on these measures. Across two studies undergraduate women (n Study 1 = 481; n Study 2 = 391) completed the Eating Disorder Examination-Questionnaire, the Body Shape Questionnaire-34, and the Depression Anxiety Stress Scales-21 (Study 1) and the Drive for Thinness Scale and the Drive for Muscularity Scale (Study 2), as well as the SM-F. Overall, the SM-F demonstrated sound content, concurrent, and convergent validity for actual and desired body fat, actual and desired muscularity, and their respective discrepancy scores.

The Interpersonal Mindfulness in Parenting Scale in Mothers of Children and Infants: Factor Structure and Associations With Child Internalizing Problems

Frontiers in Psychology, Feb 3, 2021

Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP)... more Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP), is beneficial for parents and children. However, the IMP has not been validated in English-speaking parents. Further, little is known about whether mindful parenting is similar in parents of children vs. infants, or how it reduces child internalizing problems. We sought to validate the IMP in English-speaking mothers of children and infants, and to examine relationships between the facets of mindful parenting, child internalizing problems and parent variables related to internalizing. Methods: Using confirmatory factor analyses, we examined the fit of various models of mindful parenting in English-speaking community-recruited mothers of children aged 3-18 years (n = 396) and infants aged 0-2 years (n = 320). We used regression analyses to investigate relationships between the facets of mindful parenting, child internalizing problems, and parent variables including parental experiential avoidance, unhelpful beliefs about child anxiety and accommodation of child anxiety. Results: Mindful parenting can be measured in English-speaking mothers, using either a 5-or 6-factor, 29-item version of the IMP. These versions of the IMP operate similarly for mothers of children and infants. Child internalizing problems and related parent variables were best predicted by non-judgmental acceptance of parenting in mothers of children, and emotional self-awareness and non-reactivity in mothers of infants. Conclusions: The IMP is a valid measure of mindful parenting in English-speaking mothers of children and infants. Mindful parenting predicts child internalizing problems and related parent variables, suggesting that mindful parenting programs could benefit families of children with internalizing problems, potentially by reducing parental experiential avoidance, unhelpful beliefs about or accommodation of child anxiety.

Development and Psychometric Properties of the DASS-Youth (DASS-Y): An Extension of the Depression Anxiety Stress Scales (DASS) to Adolescents and Children

Frontiers in Psychology

The Depression Anxiety Stress Scales (DASS; Lovibond and Lovibond, 1995b) is a set of psychometri... more The Depression Anxiety Stress Scales (DASS; Lovibond and Lovibond, 1995b) is a set of psychometrically sound scales that is widely used to assess negative emotional states in adults. In this project, we developed the Depression Anxiety Stress Scales for Youth (DASS-Y) and tested its psychometric properties. Data were collected from 2,121 Australian children and adolescents aged 7–18 (61% female). This sample was split randomly into a calibration group (n = 1075, 61% female) and a cross-validation group (n = 1046, 60% female). First, we used Confirmatory Factor Analysis on the calibration group to test the 3-factor DASS model on 40 items we had developed in previous exploratory studies. We then selected the best-performing 21 items based on both statistical and theoretical considerations, guided by the structure and item content of the adult DASS. We cross-validated this new 21-item model in the second half of the sample. Results indicated good fit for the final 21-item 3-factor DASS...

Physical Social Outomes - Probability and Cost Questionnaires from Szabo 2009

Preventing suicide

The British Journal of Psychiatry, 2003

Alcohol Use by Australian Actors and Performing Artists: A Preliminary Examination from the Australian Actors’ Wellbeing Study

Medical Problems of Performing Artists, Jun 1, 2020

BACKGROUND: Anecdotal and media reports suggest that actors and performing artists are vulnerable... more BACKGROUND: Anecdotal and media reports suggest that actors and performing artists are vulnerable to high levels of alcohol use. However, little empirical research is available to document the extent and correlates of alcohol use amongst these artists, particularly in an Australian context. OBJECTIVE: This study investigated alcohol use in a sample of Australian actors and other performing artists and its associations with sociodemographic background, psychological wellbeing, and work stress. METHODS: An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists. The survey included questions on sociodemographic and occupational background and psychological wellbeing (DASS-21), as well as the AUDIT questionnaire to assess self-reported alcohol consumption. A sample of 620 performing artists responded to the survey, a large majority of whom were actors. RESULTS: Australian actors and performing artists appear to consume alcohol at levels that are higher than those found in the general Australian population. About 40% of men and 31% of women were classified as drinking alcohol at potentially harmful or hazardous levels. Alcohol use was not strongly associated with age, education, or income, but it had a relationship with poorer psychological wellbeing. About 50% of respondents reported that their alcohol drinking was related to work stress as a performer. This perception was more pronounced amongst those performers who reported drinking at harmful levels. CONCLUSIONS: Australian actors and performing artists appear to be an at-risk population for harmful or hazardous alcohol use.

A randomized controlled trial of a web-based mindfulness programme for people with MS with and without a history of recurrent depression

Multiple Sclerosis Journal, Feb 7, 2022

Background: Evidence shows small positive effects associated with psychological treatments for pe... more Background: Evidence shows small positive effects associated with psychological treatments for people with multiple sclerosis (PwMS). In a recent meta-analysis, the treatment with the largest effect size was a mindfulness-based intervention (MBI). Objectives: We aimed to determine whether an Internet-delivered MBI was beneficial for PwMS. Furthermore, we aimed to investigate history of recurrent depression as a moderator of treatment outcome. Methods: Participants ( N = 132) were assessed based on whether they had a history of recurrent depression, then stratified and randomized to MBI or waitlist. Outcomes were assessed at baseline, post-intervention, and 3 and 6 months. Results: The MBI group reported significantly improved depressive symptoms (primary outcome) compared with the waitlist ( p = 0.046, Cohen’s d = 0.39). Those with a history of recurrent depression benefitted significantly more than those without ( p = 0.034, d = 0.66). There were benefits for health-related quality of life (HRQoL) in the MBI, irrespective of depression history ( p = 0.009, d = 0.5). Pain interference was less overall in the MBI group ( p &lt; 0.001, d = 0.2), but change over time did not differ from waitlist. There were no treatment effects for anxiety, pain severity or fatigue. Conclusion: The Internet-delivered MBI significantly improved depressive symptoms and HRQoL in PwMS. For depression, the benefits were greater for those with a history of recurrent depression. Trial Registration: ACTRN12618001260213, available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375598

The evaluation of an online mindfulness program for people with multiple sclerosis: study protocol

BMC Neurology, Jun 14, 2019

Background: Multiple sclerosis (MS) is a neurological disease of the central nervous system and i... more Background: Multiple sclerosis (MS) is a neurological disease of the central nervous system and is associated with many psychosocial symptoms that are difficult to manage including low mood, anxiety, fatigue and pain, as well as low health-related quality of life. Internet-based psychosocial interventions that use mindfulness-based approaches are gathering much attention in recent literature, particularly in the treatment of chronic illnesses. However, no large randomized controlled trials have been done examining the efficacy of such interventions for people with MS (PwMS). Methods/design: This study is a randomised controlled trial of an online mindfulness-based intervention (MBI) for PwMS. Participants will be randomised to receive either the MBI or offered the intervention after a waiting period. All participants will be assessed to determine whether they have a history of recurrent depressive disorder. The primary outcome will be severity of depression, according to the Centre of Epidemiology Depression Scale. Secondary outcomes will be anxiety severity, fatigue, pain and quality of life. Assessments will be conducted pre, post-treatment, at three and six-month follow-up. The online mindfulness-based program was developed in collaboration with end-users (n = 19 PwMS) who gave feedback about what would be feasible and acceptable, and the draft program was reviewed by both experts and patients. Discussion: Multiple sclerosis is the most common acquired chronic neurological disease amongst young adults and is associated with a range of symptoms that can be difficult to cope with. In face-to-face interventions, a MBI demonstrated the largest effect in a recent meta-analysis of psychological treatments for PwMS, but MBIs for PwMS have not been delivered online. Hence, this trial will confirm whether MBIs can be efficacious when delivered online. A range of symptoms are assessed as outcomes so that the nature of benefits associated with the online MBI can be ascertained. Trial registration: ACTRN12618001260213.

The Australian Actors' Wellbeing Study: A Preliminary Report

About Performance, 2015

Eating Disorder Symptoms in Australian Actors and Performing Artists

Medical Problems of Performing Artists, Dec 1, 2019

AIMS: Anecdotal evidence suggests that actors and other performing artists are under great pressu... more AIMS: Anecdotal evidence suggests that actors and other performing artists are under great pressure to conform to idealized appearances and body types. The pursuit of such appearances may trigger eating disorder symptoms, such as unhealthy attitudes towards body weight and shape. Thus far, there has been no dedicated empirical study of the prevalence of such problems in Australian actors and performing artists specifically. Therefore, this study sought to examine eating disorder symptomatology in Australian actors and performing artists. METHODS: An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists, of whom 573 individuals completed the survey. This survey gauged demographic information and eating disorder symptoms using the psychometrically validated Eating Disorder Diagnostic Scale (EDDS). RESULTS: A large proportion of actors reported unhealthy attitudes such as ‘feeling fat’ even though they are of normal weight or underweight; reported an extreme fear of gaining weight; and evaluated their self-worth based on their body weight and shape, particularly women. Results also showed that 2.5% of women in the study met the diagnostic criteria for anorexia nervosa and 13% met diagnostic criteria for bulimia nervosa based on their scores on the EDDS. DISCUSSION: Performers may be a particularly at-risk population for the development and/or maintenance for a range of eating disorders.

Different Characteristics of the Female Sexual Function Index in a Sample of Sexually Active and Inactive Women

The Journal of Sexual Medicine, Sep 1, 2017

Background: The Female Sexual Function Index (FSFI) is a widely used measurement tool to assess f... more Background: The Female Sexual Function Index (FSFI) is a widely used measurement tool to assess female sexual function along the six dimensions of desire, arousal, lubrication, orgasm, satisfaction, and pain. However, the structure of the questionnaire is not clear, and several studies have found high correlations among the dimensions, indicating that a common underlying "sexual function" factor might be present. Aim: To investigate whether female sexual function is best understood as a multidimensional construct or, alternatively, whether a common underlying factor explains most of the variance in FSFI scores, and to investigate the possible effect of the common practice of including sexually inactive women in studies using the FSFI. Methods: The sample consisted of 508 women: 202 university students, 177 patients with endometriosis, and 129 patients with polycystic ovary syndrome. Participants completed the FSFI, and confirmatory factor analyses were used to test the underlying structure of this instrument in the total sample and in samples including sexually active women only. Outcomes: The FSFI is a multidimensional self-report questionnaire composed of 19 items. Results: Strong positive correlations were found among five of the six original factors on the FSFI. Confirmatory factor analyses showed that in the total sample items loaded mainly on the general sexual function factor and very little variance was explained by the specific factors. However, when only sexually active women were included in the analyses, a clear factor structure emerged, with items loading on their six specific factors, and most of the variance in FSFI scores was explained by the specific factors, rather than the general factor. University students reported higher scores, indicating better functioning compared with the patient samples. Clinical Translation: The reliable and valid assessment of female sexual function can contribute to better understanding, prevention, and treatment of different sexual difficulties and dysfunctions. Strengths and Limitations: This study provides a rigorous statistical test of the structure of the FSFI and an explicit decision rule for categorizing sexually inactive women. Limitations include a lack of control over the circumstances of data collection. Conclusion: This study supports the use of the FSFI as a multidimensional measurement of female sexual function but highlights the need to establish clear decision rules for the inclusion or exclusion of sexually active and inactive respondents. Hevesi K, Mészáros V, Kövi Z, et al. Different Characteristics of the Female Sexual Function Index in a Sample of Sexually Active and Inactive Women.

The Bifactor Model of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS)-An Alternative Measurement Model of Burnout

Stress and Health, Jan 24, 2013

The purpose of the present study was to examine the construct validity of the Hungarian language ... more The purpose of the present study was to examine the construct validity of the Hungarian language version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). A sample of 653 healthcare professionals (420 physicians and 233 nurses and nursing assistants) completed the MBI-HSS. A series of confirmatory factor analyses showed that a hierarchical bifactor model including a global burnout factor and three specific factors of emotional exhaustion, depersonalization and reduced personal accomplishment had the closest fit to the data, compared with an alternative second-order three-factor hierarchical model as well as to non-hierarchical one-factor, two-factor, three-factor, four-factor and five-factor models. However, only the global burnout factor and the specific personal accomplishment factor explained a considerable unique proportion of variance in observed scores. Our study confirms the validity of the MBI-HSS and suggests an alternative structural model, which may contribute to further understanding of the burnout construct.

Psychological Well-Being of Australian Actors and Performing Artists: Life Satisfaction and Negative Affect

Medical Problems of Performing Artists, Jun 1, 2022

BACKGROUND: Anecdotal evidence and media reports suggest that actors and other performing artists... more BACKGROUND: Anecdotal evidence and media reports suggest that actors and other performing artists experience high levels of depression, anxiety, and stress. However, no empirical study has examined the psychological well-being of this professional group. OBJECTIVE: The Australian Actors’ Wellbeing Study (AWS) was conducted to examine the general wellbeing of Australian actors and performing artists. The present paper, reporting on data from the AWS, focuses on two aspects of respondents’ psychological well-being: life satisfaction and the experience of negative affect. METHODS: An online survey including several questionnaires was distributed to the Equity Foundation membership representing Australian actors. We report results from the Satisfaction with Life Scale (SWLS) and the Depression Anxiety Stress Scales (DASS) and examine their associations with respondents’ sociodemographic and occupational background, including their relationship status and any relationship stress, income from performing, and time taken away from performing. RESULTS: A sample of 782 Australian actors responded to the survey, with 582 participants completing the DASS and 568 the SWLS. Participants reported lower levels of life satisfaction and higher levels of depression, anxiety, and stress than found in the Australian general population. Being in a relationship was associated with better psychological well-being; however, work stress often impacted negatively on relationships. Income had little association with psychological well-being, unless the respondent felt under financial stress. Respondents who took extended periods of time away from performing reported less life satisfaction and more depression than others. CONCLUSION: Australian actors may be at a high risk for poor psychological health. Further research is necessary to establish causality among the variables we examined and to investigate protective factors that may increase well-being in the context of the performing arts industry.

Development of a Web-Based Mindfulness Program for People With Multiple Sclerosis: Qualitative Co-Design Study

Journal of Medical Internet Research, Mar 2, 2021

Background: Mindfulness-based stress reduction is an efficacious treatment for people with chroni... more Background: Mindfulness-based stress reduction is an efficacious treatment for people with chronic health problems; however, it is highly intensive and time-consuming, which is a barrier for service provision. Objective: This study aims to develop an internet-delivered adapted version of mindfulness-based stress reduction for people with multiple sclerosis to make the intervention more accessible. Methods: We co-designed a web-based mindfulness program with end users, that is, people with multiple sclerosis (N=19). Iterative feedback was also collected from a subsample of the initial group of end users (n=11), and the program was reviewed by experts (n=8). Results: We identified three main themes common to people with multiple sclerosis: dealing with uncertainty and fears for the future, grief and loss, and social isolation. These themes were incorporated into narratives throughout the program. People with multiple sclerosis who reviewed the program gave feedback that the program was relatable, feasible, and acceptable. Experts agreed that the program appropriately represented the main tenets of mindfulness. Iterative feedback was used to further refine the program. Conclusions: The web-based mindfulness program that we developed was viewed positively by both experts and end users. The program reflects common concerns for people with multiple sclerosis and has the potential to meet important unmet psychological needs. A randomized controlled trial was planned to determine the efficacy of the program.

Randomised controlled trial of cognitive behaviour therapy versus mindfulness for people with rheumatoid arthritis with and without a history of recurrent depression: study protocol and design

BMJ Open, May 1, 2022

, et al. Randomised controlled trial of cognitive behaviour therapy versus mindfulness for people... more

Interpersonal Mindfulness in Parenting Scale--English Expanded Version

PsycTESTS Dataset

Mindful parenting is the extension of intra-personal mindfulness to inter-personal processes by d... more Mindful parenting is the extension of intra-personal mindfulness to inter-personal processes by developing and fostering mindfulness during interactions with a child when acting in the role of a parent. While some empirical evidence points to various benefits of mindful parenting both for the parent and the child, suitable measurement tools for mindful parenting are still being developed, especially for use in non-Western countries such as Korea. The present study involved development of a Korean version of the Interpersonal Mindfulness in Parenting (IM-P) scale using a large sample of Korean parents (n = 554) recruited online and a second, replication sample of Korean parents with children attending kindergarten (n = 283). Using an iterative approach of exploratory and confirmatory factor analysis guided by conceptual criteria, an 18-item Korean version of the instrument (IM-P-K) met psychometric criteria of classical test theory. Rasch analysis confirmed internal validity of this solution and also produced algorithms to convert the total ordinal-level summary scores to interval-level data. While the reliability of the six individual three-item subscales was only marginally acceptable, the reliability of the total interval-transformed score was excellent. The IM-P-K total scores correlated in expected directions with various other psychological constructs known to be associated with mindfulness, such as self-compassion, depression, psychological well-being, and perceived stress. This 18-item IM-P-K thus offers a suitable self-report instrument to investigate mindful parenting in Korean samples.

The precarious lives of actors

Australasian Drama Studies, Apr 1, 2018

This article investigates the precarious lives of working actors, drawing upon responses to the 2... more This article investigates the precarious lives of working actors, drawing upon responses to the 2012 Actors' Wellbeing Survey, to show how reliant actors are upon highly casualised work to supplement earnings from acting. The precarity of actors' lives manifests in a range of challenges, including, in addition to and partially as a result of, financial hardship, stress on relationships and senses of self-worth.

The Interpersonal Mindfulness in Parenting Scale in Mothers of Children and Infants: Factor Structure and Associations With Child Internalizing Problems

Frontiers in Psychology, 2021

Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP)... more Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP), is beneficial for parents and children. However, the IMP has not been validated in English-speaking parents. Further, little is known about whether mindful parenting is similar in parents of children vs. infants, or how it reduces child internalizing problems. We sought to validate the IMP in English-speaking mothers of children and infants, and to examine relationships between the facets of mindful parenting, child internalizing problems and parent variables related to internalizing.Methods: Using confirmatory factor analyses, we examined the fit of various models of mindful parenting in English-speaking community-recruited mothers of children aged 3–18 years (n = 396) and infants aged 0–2 years (n = 320). We used regression analyses to investigate relationships between the facets of mindful parenting, child internalizing problems, and parent variables including parental experiential ...

Improving children’s eating patterns: intervention programs and underlying principles

Eating patterns affect long-term health. Although dietary guidelines now recommend an increase in... more Eating patterns affect long-term health. Although dietary guidelines now recommend an increase in the consumption of fruit and vegetables and a reduction in daily energy intake derived from sugars and fats, evidence shows that in Australia, the UK and the USA children’s diets are widely discrepant from that which is thought to be desirable for good health. This article briefly describes the theoretical models underlying dietary interventions, especially those with children. The paper then outlines the major interventions from the published literature that have aimed to improve children’s eating patterns, and reflects on their efficacy primarily within the context of existing knowledge about the factors thought to influence children’s food choices and their health behaviour generally. The paper concludes by considering some of the methodological issues that are important in designing and establishing the efficacy of dietary interventions for children.

Preventing major depression in young people

British Journal of Psychiatry, 2002