Kenneth I Pakenham

University of Queensland , Brisbane, Queensland, Australia

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Publications (52)130.15 Total impact

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    ABSTRACT: Multiple health behavior change can ameliorate adverse effects of cancer. The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life. A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care. Posttraumatic growth, spirituality, acceptance, mindfulness, distress, and quality of life were assessed at baseline, 6 and 12 months. Significant intervention effects were observed for posttraumatic growth at 6 (7.5, p < 0.001) and 12 months (4.1, p = 0.033), spirituality at 6 months (1.8, p = 0.011), acceptance at 6 months (0.2, p = 0.005), and quality of life at 6 (0.8, p = 0.049) and 12 months (0.9, p = 0.037). The intervention improved psychosocial outcomes and quality of life (physical well-being) at 6 months with most effects still present at 12 months. (Trial Registration Number: ACTRN12608000399392).
    Annals of Behavioral Medicine 04/2014; · 4.20 Impact Factor
  • K I Pakenham, S Cox
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    ABSTRACT: Few studies have examined the effects of parental MS on children, and those that have suffered from numerous methodological weaknesses, some of which are addressed in this study. This study investigated the effects of parental MS on children by comparing youth of a parent with MS to youth who have no family member with a serious health condition on adjustment outcomes, caregiving, attachment and family functioning. A questionnaire survey methodology was used. Measures included youth somatisation, health, pro-social behaviour, behavioural-social difficulties, caregiving, attachment and family functioning. A total of 126 youth of a parent with MS were recruited from MS Societies in Australia and, were matched one-to-one with youth who had no family member with a health condition drawn from a large community sample. Comparisons showed that youth of a parent with MS did not differ on any of the outcomes except for peer relationship problems: adolescent youth of a parent with MS reported lower peer relationship problems than control adolescents. Overall, results did not support prior research findings suggesting adverse impacts of parental MS on youth.
    Psychology & Health 07/2013; · 1.95 Impact Factor
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    ABSTRACT: PURPOSEColorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. METHODS In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form-36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m(2)], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months.ResultsAt 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (-0.9 kg/m(2); P = .001), energy from total fat (-7.0%; P = .006), and energy from saturated fat (-2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. CONCLUSION The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.
    Journal of Clinical Oncology 05/2013; · 18.04 Impact Factor
  • Kenneth I Pakenham, Christina Samios
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    ABSTRACT: This study investigated the roles of mindfulness and acceptance on adjustment in couples coping with multiple sclerosis (MS) by examining the effects of an individual's mindfulness and acceptance on their own adjustment (actor effects) and the effects of their partner's mindfulness and acceptance on their adjustment (partner effects) using the Actor-Partner Interdependence Model. The study was a cross-sectional standard dyadic design that collected data from couples coping with MS. Sixty-nine couples completed measures of mindfulness, acceptance and adjustment (depression, anxiety, life satisfaction, positive affect and relationship satisfaction). As hypothesised there were actor effects of mindfulness and acceptance on better adjustment, however, the beneficial actor effects of mindfulness were only evident on depression and anxiety. The actor effects of both mindfulness and acceptance on relationship satisfaction were moderated by MS status. Regarding partner effects, there was support for the beneficial impact of acceptance on partner relationship satisfaction. In addition, the partner effect of acceptance moderated the actor effect of acceptance on depression, such that the actor effect on lower depression was weaker when the partner reported high acceptance. Findings support the roles of mindfulness and acceptance in shaping individual and dyadic adjustment in couples coping with chronic illness.
    Journal of Behavioral Medicine 06/2012; · 3.10 Impact Factor
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    Johanna Stafford-Brown, Kenneth I Pakenham
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    ABSTRACT: Clinical psychology trainees (CPTs) are vulnerable to high stress, which can adversely affect their personal and professional functioning. This study evaluated the effectiveness of a group acceptance and commitment therapy (ACT) informed stress management intervention for CPTs. Outcome measures were work-related stress, distress, life satisfaction, counseling self-efficacy, self-compassion, and therapeutic alliance. A cohort-controlled design, where an experimental group (n = 28) was compared with a waitlist control group (n = 28), was utilized, with a 10-week follow-up. Group comparisons showed statistically significant intervention effects for the main outcome measures, which were maintained at follow-up. Mediational analyses showed that changes on most outcomes were mediated by ACT mindfulness and acceptance processes. Findings support the effectiveness of a group ACT program for CPTs regarding stress reduction and improving therapist qualities.
    Journal of Clinical Psychology 05/2012; 68(6):592-13. · 2.12 Impact Factor
  • Kenneth I Pakenham, Julia Tilling, Julia Cretchley
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    ABSTRACT: The needs of parents affected by multiple sclerosis (MS) have been neglected. Data are required to inform the development of evidenced-based clinical practice, services, and policies that will maximize the parenting capacities of parents with MS and their partners, while at the same time protect the welfare of children. The purpose of this exploratory study was to provide descriptive data on the difficulties and resources associated with parenting with MS. Qualitative data on parenting difficulties and resources were obtained from parents with MS and their partners in the form of written responses to 2 open-ended questions in a questionnaire survey. A total of 145 parents with MS and 91 partners were recruited through MS societies in Australia; 119 parents with MS and 64 partners provided qualitative data. The data were analyzed using the Leximancer text analysis software. Ten difficulty themes emerged (ordered from the most to the least strong): activities, time, MS, fatigue, sons, partner, daughters, housework, family, and mood. Some of these difficulties were more closely affiliated with 1 parent, whereas others were shared, affecting both parents. Eight resource themes emerged: school, time, assistance, chores, friends and family, spouse, sons, and driving. Parents with MS and partners accessed common and unique resources. The complex array of interacting parenting difficulties was mirrored by a similarly multifaceted assortment of resources required to address the parenting difficulties. Findings delineate key interrelated parenting needs that can be targeted by services and policy development.
    Rehabilitation Psychology 02/2012; 57(1):52-60. · 1.91 Impact Factor
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    Kenneth I Pakenham, Stephen Cox
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    ABSTRACT: Objective: Parental illness (PI) may have adverse impacts on youth and family functioning. Research in this area has suffered from the absence of a guiding comprehensive framework. This study tested a conceptual model of the effects of PI on youth and family functioning derived from the Family Ecology Framework (FEF; Pedersen & Revenson, 2005). Method. A total of 85 parents with multiple sclerosis and 127 youth completed questionnaires at Time 1 and 12 months later at Time 2. Results. Structural equation modeling results supported the FEF with regards to physical-illness disability. Specifically, the proposed mediators (role redistribution, stress, and stigma) were implicated in the processes that link parental disability to several domains of youth adjustment. The results suggest that the effects of parental depression (PD) are not mediated through these processes; rather, PD directly affects family functioning, which in turn mediates the effects onto youth adjustment. Family functioning further mediated between PD and youth well-being and behavioral-social difficulties. Conclusions. Although results support the effects of parental-illness disability on youth and family functioning via the proposed mediational mechanisms, the additive effects of PD on youth physical and mental health occur through direct and indirect (via family functioning) pathways, respectively. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Health Psychology 12/2011; 31(5):580-90. · 3.83 Impact Factor
  • Christina Samios, Kenneth I Pakenham, Kate Sofronoff
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    ABSTRACT: Parents of children with Asperger syndrome face many challenges that may lead them to search for meaning by developing explanations for (sense making) and finding benefits (benefit finding) in having a child with special needs. Although family theorists have proposed that finding meaning occurs interpersonally, there is a dearth of empirical research that has examined finding meaning at the couple level. This study examined sense making and benefit finding in 84 couples who have a child with Asperger syndrome by using the Actor-Partner Interdependence Model (Kenny et al., 2006) to examine actor effects (i.e. the extent to which an individual's score on the predictor variable impacts his or her own level of adjustment) and partner effects (i.e. the extent to which an individual's score on the predictor variable has an impact on his or her partner's level of adjustment) of sense making and benefit finding on parental adjustment. Results demonstrated that parents' benefit finding related to greater anxiety and parents' sense making related to not only their own adjustment but also their partner's adjustment. Results highlight the importance of adopting an interpersonal perspective on finding meaning and adjustment. Limitations, future research and clinical implications are also discussed.
    Autism 09/2011; 16(3):275-92. · 2.27 Impact Factor
  • Christina Mackay, Kenneth I Pakenham
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    ABSTRACT: There is a paucity of theory guided longitudinal research into how carers of an adult with mental illness adapt to caregiving. This study examined changes in carer adjustment over 12 months and identified risk and protective factors using stress/coping theory. Eighty-seven carers completed questionnaires at Time 1 and 12 months later (Time 2). The risk/protective factors were background variables, coping resources, appraisals, and coping strategies. Adjustment outcomes were stable over 12 months. Stress/coping variables were associated with one or more Time 2 adjustment outcomes when controlling for initial adjustment and the direction of these associations were consistent with predictions. Findings support the application of stress/coping theory to guide identification of modifiable risk and protective factors associated with caregiver adjustment.
    Journal of Clinical Psychology 08/2011; 67(10):1064-79. · 2.12 Impact Factor
  • Christina Mackay, Kenneth I Pakenham
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    ABSTRACT: This study investigated the utility of a stress and coping framework for identifying factors associated with adjustment to informal caregiving to adults with mental illness. Relations between stress and coping predictors and negative (distress) and positive (positive affect, life satisfaction, benefit finding, health) carer adjustment outcomes were examined. A total of 114 caregivers completed questionnaires. Predictors included relevant background variables (carer and care recipient characteristics and caregiving context), coping resources (optimism, social support, carer-care recipient relationship quality), appraisal (threat, control, challenge) and coping strategies (problem-focused, avoidance, acceptance, meaning-focused). Results indicated that after controlling for relevant background variables (burden, caregiving frequency, care recipient symptom unpredictability), better caregiver adjustment was related to higher social support and optimism, better quality of carer-care recipient relationship, lower threat and higher challenge appraisals, and less reliance on avoidance coping, as hypothesised. Coping resources emerged as the most consistent predictor of adjustment. Findings support the utility of stress and coping theory in identifying risk and protective factors associated with adaptation to caring for an adult with mental illness.
    Community Mental Health Journal 06/2011; 48(4):450-62. · 1.03 Impact Factor
  • Kenneth I Pakenham, Stephen Cox
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    ABSTRACT: This study explored youth caregiving for a parent with multiple sclerosis (MS) from multiple perspectives, and examined associations between caregiving and child negative (behavioural emotional difficulties, somatisation) and positive (life satisfaction, positive affect, prosocial behaviour) adjustment outcomes overtime. A total of 88 families participated; 85 parents with MS, 55 partners and 130 children completed questionnaires at Time 1. Child caregiving was assessed by the Youth Activities of Caregiving Scale (YACS). Child and parent questionnaire data were collected at Time 1 and child data were collected 12 months later (Time 2). Factor analysis of the child and parent YACS data replicated the four factors (instrumental, social-emotional, personal-intimate, domestic-household care), all of which were psychometrically sound. The YACS factors were related to parental illness and caregiving context variables that reflected increased caregiving demands. The Time 1 instrumental and social-emotional care domains were associated with poorer Time 2 adjustment, whereas personal-intimate was related to better adjustment and domestic-household care was unrelated to adjustment. Children and their parents exhibited highest agreement on personal-intimate, instrumental and total caregiving, and least on domestic-household and social-emotional care. Findings delineate the key dimensions of young caregiving in MS and the differential links between caregiving activities and youth adjustment.
    Psychology & Health 06/2011; 27(3):324-46. · 1.95 Impact Factor
  • Kenneth I Pakenham
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    ABSTRACT: Carers of persons with mental illness engage in many caregiving tasks and spend considerable time on these activities. This caregiving is of immense social and economic value, but often at a high cost to carers. Investigation of the specific caregiving tasks these carers undertake and how these may affect their adjustment has been neglected. This study examines: (1) the dimensional and psychometric structure of the Caregiving Tasks in Caring for an Adult with Mental Illness Scale (CTiCAMIS), (2) relations between caregiving tasks and various caregiving parameters, and (3) associations between caregiving tasks and adjustment cross-sectionally and over 12 months. Participants were 114 carers of adults with a mental illness who completed questionnaires at time 1 and 12 months later (time 2). Factor analyses showed that the CTiCAMIS could be represented by a single dimension or three caregiving domains: instrumental care, activities of daily living care, psychosocial care. The CTiCAMIS factors were psychometrically sound and evidenced differential relations with most carer, care recipient and caregiving context variables, and were correlated with adjustment outcomes concurrently and over 12 months after controlling for initial adjustment. Findings delineate the key dimensions of mental health caregiving and show the differential links between caregiving activities and caregiving parameters and carer adjustment.
    International Journal of Behavioral Medicine 04/2011; 19(2):186-98. · 2.63 Impact Factor
  • Machelle Rinaldis, Kenneth I Pakenham, Brigid M Lynch
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    ABSTRACT: This study has used the structural equation modelling to examine the role of benefit-finding (BF) in the context of the stress and coping model. In the study, 1276 individuals diagnosed with colorectal cancer completed a written questionnaire and telephone interview at around 4.5 months (on average) and 12 months post-diagnosis. Analyses revealed that the final model fit the data, where stress, coping and BF accounted for 63% of the variance in Time 1 quality of life (QOL). Threat appraisal, coping resources, avoidant coping and BF directly impacted on Time 1 QOL, while threat appraisal, social support and approach coping directly impacted on BF. Approach coping and BF had differential relationships with stress, coping resources and outcomes, indicating that BF may not be a meaning-based coping strategy, as proposed by Folkman [Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207–1221]. Theoretical and clinical implications are discussed.
    Psychology & Health 03/2011; 27(2):159-77. · 1.95 Impact Factor
  • Rachel V Costa, Kenneth I Pakenham
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    ABSTRACT: Few studies have examined psychological adjustment in thyroid cancer (TC) patients and no published studies have investigated benefit finding (BF) in this population. This study examined the relationship between BF and adjustment in TC using an expanded conceptualisation of adjustment that incorporated higher order cognitive and motivational states (HOCMS) and health behaviour changes, and a BF measure that accounted for positive and negative changes. Partner ratings of patient's BF and health behaviour changes were examined as sources of external validity for these constructs. 154 TC patients and 32 partners completed questionnaires. Findings supported the prediction that BF would be associated with greater positive affect and positive health behaviour change, and better outcomes on the HOCMS of adjustment. After controlling for demographics and cancer stress, BF evidenced associations with greater positive affect, wisdom, spiritual wellbeing, and lifestyle changes. Results suggest that BF is related to health behaviour change that is corroborated by significant others and is strongly related to the existentially oriented adjustment outcomes.
    Psycho-Oncology 03/2011; 21(7):737-44. · 3.51 Impact Factor
  • Kenneth Ian Pakenham, Megan Fleming
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    ABSTRACT: This study examines relations between acceptance as defined in Acceptance and Commitment Therapy (ACT) and adjustment to multiple sclerosis (MS). A first step in this investigation was the development of a measure of acceptance of MS called the MS Acceptance Questionnaire (MSAQ). Consistent with prior findings and theoretical propositions, it was predicted that acceptance would be associated with better adjustment to MS (lower distress and higher positive affect, life satisfaction and marital adjustment and better health). A total of 128 persons with MS completed measures of demographics, illness and adjustment at Time 1 and measures of acceptance and adjustment 12 months later (Time 2). Factor analyses of the MSAQ revealed two factors, action and willingness. Associations between the MSAQ and other validated acceptance measures supported convergent validity. As predicted, after controlling for the effects of initial adjustment and relevant demographic and illness variables, greater acceptance was related to better adjustment, although the action factor emerged as the strongest predictor of better adjustment. This is the first study to examine the role of acceptance (as defined in ACT) in adjusting to MS over time and as such provides a first step for further investigation of acceptance in MS.
    Psychology & Health 01/2011; 26(10):1292-309. · 1.95 Impact Factor
  • Michael J Ireland, Kenneth I Pakenham
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    ABSTRACT: This study aimed to (1) examine relations between youth adjustment and three sets of predictors: parental illness/disability characteristics, caregiving, and parent-child attachment, and (2) explore differences on these variables between youths of parental physical illness/disability and youths of parental mental illness. Eighty-one youths between 10 and 25 years of a parent with a physical illness/disability (35%) or a mental illness (43%) completed a series of self-report measures assessing perceived characteristics of the parent's illness/disability, caregiving experiences, and adjustment outcomes. Results revealed a set of predictors of poorer youth adjustment: gradual illness/disability onset, being male, isolation, lower perceived maturity, and less choice in caregiving. Youths of parental mental illness differed from youths of parental physical illness/disability on emotional distress (worry and discomfort) dimensions of caregiving. Youth-parent attachment security was associated with youth caregiving and there was a trend for attachment to vary according to parental illness/disability type. Findings highlight young caregiving as an important target for service and policy planning.
    Psychology Health and Medicine 12/2010; 15(6):632-45. · 1.38 Impact Factor
  • Nicola W Burton, Kenneth I Pakenham, Wendy J Brown
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    ABSTRACT: Physical activity can provide psychological benefits, but there is little research on psychologists' promoting activity as part of psychological treatment. This study assessed psychologists' attitudes to and frequency of providing activity advice and counseling. A mail questionnaire sent to 620 psychologists provided 236 responses (38%). Items assessed frequency of providing activity advice and counseling, confidence to provide activity advice and counseling, perceived efficacy of activity for managing physical and psychological conditions, acceptability of activity advice and counseling, knowledge of national activity guidelines, exposure to training in activity promotion, and practice and sociodemographic characteristics. Data were analysed using descriptive statistics and multiple linear regression analyses. Among respondents, 83% reported often recommending activity, 67% often provided activity advice, and 28% often did activity counseling. There was a high level of acceptability for physical activity promotion as part of psychological treatment. Over 80% of respondents were confident to provide general activity advice, discuss activity options, and problem solve barriers to activity, but less than half were confident to monitor activity levels or to tailor advice. Factors significantly associated with providing activity advice and counseling were: if the psychologist reported doing regular exercise, confidence to provide general activity advice, high acceptability, working in private practice, and clients presenting with general health and well-being issues (p < 0.05). Seventy-two percent of respondents were interested in attending a workshop on providing activity advice and counseling. Many psychologists are willing and potentially able to promote physical activity as part of psychological treatment and would be likely to participate in relevant professional development.
    International Journal of Behavioral Medicine 04/2010; 17(4):287-97. · 2.63 Impact Factor
  • Claudia Jardim, Kenneth Pakenham
    Australian Psychologist 03/2010; 45(1):50-58. · 0.61 Impact Factor
  • Amber Fitzell, Kenneth I Pakenham
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    ABSTRACT: This study examined relations between stress and coping predictors and negative (distress) and positive (positive affect, life satisfaction, positive states of mind, health) adjustment outcomes in colorectal cancer caregivers. A total of 622 caregivers and their care-recipients completed questionnaires and interviews. Predictors included caregiving parameters, social support, appraisal (stress, control, challenge), and coping strategies (problem-solving, avoidance, substance use, religion, humor, seeking social support). Regression analyses indicated that after controlling for the effects of relevant caregiving parameters (caregiver age, gender and paid employment status, care-recipient quality of life, cancer stage), better caregiver adjustment was related to higher social support, lower stress and higher challenge appraisals, and less reliance on avoidance and substance use coping, as hypothesized. Stress appraisal emerged as the strongest and most consistent predictor of all adjustment outcomes. Findings support the utility of the stress and coping model of adjustment to caregiving in colorectal cancer.
    Psycho-Oncology 12/2009; 19(11):1171-8. · 3.51 Impact Factor
  • Michael Shelley, Kenneth Ian Pakenham, Ian Frazer
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    ABSTRACT: Previous studies offer contradictory evidence regarding the effects of cortisol changes on health outcomes for surgical heart patients. Increased cortisol and inflammation have been related to psychological stress while separate studies have found an inverse relation between cortisol and inflammation. Psychological preparations for surgery can reduce stress and improve outcomes and may interact with cortisol changes. Following from these relationships, we hypothesised that a preparation for surgery will interact with changes in cortisol to affect outcomes. Measures were the SF 36 General Health and Activities, medical visits and satisfaction. Eighty-five patients were randomly assigned to standard care plus a psychological preparation or standard care alone using a single-blind methodology. Data on psychological and biological functioning were collected at admission, 1 day prior and 5 days post-surgery, and 12-months after hospital discharge. General health and activities, and medical visits were related to the interaction of cortisol change and psychological preparation in support of the hypothesis. Patients were more satisfied in the preparation group than controls. Based on these findings, some outcomes from psychological preparations may be affected by changes in levels of cortisol. These results caution against a one-size-fits-all approach to psychological preparations.
    Psychology & Health 12/2009; 24(10):1139-52. · 1.95 Impact Factor