http://hdl.handle.net/10453/148720 2026-04-11T04:45:25Z http://hdl.handle.net/10453/187901 Title: "How well do we know our patients?": Further validation of a complexity rating scale for HIV. Authors: Begley, K; Smith, D; Wand, H; Chan, D; Furner, V; Kelly, ML; McGrath, P; Hennessy, R; Price, A; Purnomo, L; Bowden, BH; Bulsara, SM Abstract: BACKGROUND: Despite advances in the management and treatment of HIV, identifying risks for disengagement are essential to maximize positive outcomes. The current study investigated the validity of the Clinical Complexity Rating Scale for HIV (CCRS-HIV), a risk-prediction tool, by assessing agreement between patient and clinician scores of patient complexity. METHODS: 207 patients completed the patient version of the CCRS-HIV (CCRS-HIVP), and six Attending Medical Officers (AMOs) caring for those individuals completed the original clinician version (CCRS-HIVC). Kappa statistics, sensitivity and specificity were used to assess patient-clinician agreement. RESULTS: Patient-clinician agreement was highest for problematic crystal methamphetamine use (86%), polypharmacy (84%) and other physical health concerns (67%). Cut-offs of 40 and 45 for the total CCRS-HIV score were identified as most appropriate, with high sensitivity (79.31% and 76.0% respectively). CONCLUSIONS: Overall agreement between the clinician and patient complexity scores was high. These findings provide further evidence of the validity of the scale. The study demonstrates that the unique role of AMOs at the center contributes to them knowing their patients well, allowing them to manage and refer when required for interdisciplinary care which likely contributes to their ongoing engagement in care and may account for the high level of agreement. 2024-12-01T00:00:00Z http://hdl.handle.net/10453/187731 Title: Predictors of outcome in self-guided internet-delivered cognitive-behavior therapy for obsessive-compulsive disorder: A preliminary investigation. Authors: Wootton, BM; McDonald, S; Karin, E; Titov, N; Dear, BF Abstract: Internet-delivered cognitive-behavioral therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD). ICBT can be delivered in a self-guided or clinician-guided format. While a literature is emerging on the predictors of response to clinician-guided ICBT, there is a lack of research examining the predictors of response to self-guided ICBT. The aim of the present study was to examine predictors of outcome in a large sample of participants with OCD who commenced a self-guided ICBT intervention. One hundred and fifty-seven participants (Mage = 34.82; SD = 10.49; 78% female) were included in the study. Regression analyses were conducted to determine clinical and demographic predictors of (1) posttreatment symptom severity and (2) a clinically meaningful treatment response for both the intention-to-treat (ITT) and completer samples. The regression models significantly predicted posttreatment outcome for both the ITT (F(8, 148) = 15.844, p < .001) and completer sample (F(8, 101) = 5.929, p < .001), explaining 46% and 34% of the variance respectively. Higher baseline OCD severity, younger age, experiencing higher contamination or symmetry symptoms, and a history of past treatment were all found to be significantly associated with higher posttreatment severity in the ITT sample. In the completer sample only higher baseline OCD severity and severity of harm-related obsessions and checking compulsions was significantly associated with higher posttreatment severity. When predicting treatment response the regression models for both the ITT and completer sample were nonsignificant. 2024-09-01T00:00:00Z http://hdl.handle.net/10453/187730 Title: Correlates of depression in individuals with obsessive compulsive disorder. Authors: Hathway, T; McDonald, S; Melkonian, M; Karin, E; Titov, N; Dear, BF; Wootton, BM Abstract: The existing literature examining the correlates of depression in individuals with obsessive compulsive disorder (OCD) is characterized by inconsistent results. The aim of the current study was to replicate and extend the literature by exploring whether various clinical and demographic factors are related to the occurrence of depression in a large sample (N = 243) of individuals with OCD (M age = 33.00; SD = 12.47; 74% female). Individuals with OCD who had elevated comorbid depressive symptoms [Patient Health Questionnaire-9 item (PHQ-9) ≥10] scored significantly higher on all OCD symptom subtypes (p range < .001-.048), had greater obsessive and compulsive severity (ps < .001), scored higher on perfectionism (p < .001), and had higher disgust sensitivity and propensity scores (ps < .001) compared with individuals who did not have comorbid depressive symptoms (PHQ-9 < 10). Of these variables, obsession severity (β = 0.22, p = .004), OCD contamination subtype (β = 0.16, p = .032) and perfectionism (β = 0.25, p < .001) were found to be associated with depressive symptoms on the PHQ-9. The findings of this study contribute to the understanding of factors which are associated with depression comorbidity in individuals with OCD. 2024-11-01T00:00:00Z http://hdl.handle.net/10453/187729 Title: Acceptability of internet-delivered cognitive behavioural therapy for adults with symptoms of obsessive-compulsive disorder: A meta-analysis. Authors: Waks, S; Moses, K; Wootton, BM Abstract: OBJECTIVES: Obsessive-compulsive disorder (OCD) is a chronic mental health disorder. Internet-delivered cognitive behaviour therapy (ICBT) is demonstrated to be effective for OCD; however little is known about the acceptability of the treatment. Therefore the aim of this study was to examine the acceptability of ICBT for adults with OCD symptoms using a meta-analytic approach. METHOD: Seventeen studies (N = 1661; Mage range = 28-41 years; 58%-93% female) were included in this analysis. RESULTS: The random effects pooled estimates indicated that 16.3% (95% CI: 9.8%-25.7%) of participants did not commence the treatment once they were enrolled in the study, 27.6% (95% CI: 19.0%-38.2%) did not complete the treatment, and 27.0% (95% CI: 18.2%-38.0%) did not complete the post-treatment questionnaires of the study. The mean score on the Client Satisfaction Questionnaire ranged from 22.4 to 26.5. Overall, pooled estimates indicated that 81.6% (95% CI: 76.1%-86.0%) of participants were satisfied with the ICBT intervention and 84.7% (95% CI: 72.8%-92.0%) indicated that they would recommend the treatment to a friend. Some of the acceptability moderator analyses indicated that self-guided ICBT interventions had lower levels of acceptability compared with clinician-guided interventions. However, given low power, these results should be considered preliminary. CONCLUSIONS: This study has important implications in the dissemination of ICBT for OCD. 2024-09-01T00:00:00Z