Lexine A Stapinski’s research while affiliated with The University of Sydney and other places

Introduction Where a person lives, the characteristics of their housing and neighbourhood environment influence their exposure to climate-related hazards and vulnerability to associated mental health impacts. This suggests that the built environment may be a promising focus for integrated policy responses to climate change and public mental health challenges. However, few empirical studies have focused on the role of the built environment as an important mediator of climate-attributable mental health burden. The proposed scoping review seeks to identify and synthesise existing conceptual models and frameworks linking climate change to mental health via built environment pathways. We aim to provide a preliminary overview of the housing and neighbourhood pathways through which climate change may impact mental health, which will inform future empirical work in this emerging area of research. Methods and analysis A systematic scoping review of the global peer-reviewed and grey literature will be conducted in accordance with Arksey and O’Malley’s methodological framework and Joanna Briggs Institute recommendations. Included articles must present a conceptual model or framework incorporating relevant built environment pathways through which climate change may impact mental health and well-being. Relevant models and frameworks will be identified through systematic searches (for English-language reports) of Medline, PsycINFO, Embase, Scopus, Web of Science and grey literature databases. Two reviewers will independently screen the article titles, abstracts and full texts, with conflicts resolved by a third reviewer. Data extraction will occur using a predefined template. The presentation of findings will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, including a narrative synthesis of the role of housing and neighbourhood factors in the relationship between climate change and mental health, as identified from the existing literature. The review will lay essential foundations for future empirical research and place-based policy responses to the mental health consequences of a changing climate. Ethics and dissemination The scoping review will be a secondary analysis of published data, for which ethics approval is not required. The results will be disseminated through a peer-reviewed publication and targeted distribution to stakeholders involved in climate change, built environment and health research and policymaking. Study registration Open Science Framework: doi.org/10.17605/OSF.IO/XR74C .

Background: There is growing recognition of the physical and mental health impacts of climate change and the attendant burden on health care systems, including from the World Health Organisation, the United Nations, and national governments. However, the repercussions on 'social health'— our access to meaningful social connections and the health and quality of these relationships — is largely missing from this discourse. Social health is an important factor underpinning physical and mental health. Moreover, the quality of our social connections determines our collective ability to both adapt to and mitigate climate change, enabling us to navigate and transform our world in a response to this crisis.Methods: In this article, we propose a new framework for understanding the bidirectional relationship between climate change and poor social health. Drawing on a wide review of peer-reviewed literature, this position paper and accompanying framework underscores the importance of social health for surviving and thriving amid climate change and its necessity for effective climate change mitigation and adaptation. Findings: We posit that failure to consider social health in the context of climate policy may undermine global health efforts and climate change action. Interpretation: We highlight the diverse pathways by which climate change affects social (ill)health and provide examples of how social health considerations could be integrated into climate mitigation and adaptation strategies.

Aims: To examine trends in vaping prevalence, frequency, and associated factors in Australia, with a focus on the relationship between vaping, smoking, and mental health among young people aged 14–25.Design, Setting and Participants: A repeated cross-sectional analysis was conducted using data from the National Drug Strategy Household Surveys (NDSHS) for 2016, 2019, and 2022/23.Measurements: Key measurements include the prevalence and frequency of vaping, smoking status, rates of mental health disorders and psychological distress, and use of e-cigarettes for smoking cessation. Data were disaggregated by year of survey to assess trends over time.Findings: The study revealed a marked increase in vaping prevalence among young people, with a shift towards more frequent use. In 2022/23, 62% of young people who had ever vaped reported never having smoked before initiating e-cigarette use. Regular vaping was significantly more common among individuals with mental health disorders or high psychological distress. While e-cigarettes showed some role in smoking cessation, only 1–3% of young people who used e-cigarettes to quit smoking were no longer smoking or vaping. In 2022/23, over 50% of young people who had used e-cigarettes for smoking cessation reported they could not stop or cut down vaping in the previous 12 months. Conclusion: The findings highlight the urgent need for targeted interventions to address the rising prevalence of vaping among young people, particularly those with mental health challenges. Recommendations include partnering with youth in policy and practice development, enhancing clinician training, conducting priority population research, developing targeted policy strategies for youth mental health services, and improving school-based prevention and intervention programs.

Social anxiety disorder (SAD) and alcohol use disorder (AUD) are prevalent disorders that often co-occur. SAD onset typically precedes that of AUD, and co-occurrence of the two disorders is associated with greater symptom severity than either condition alone. This chapter reviews current evidence about psychological treatment of co-occurring SAD and AUD. While people with co-occurring SAD-AUD can benefit from single-disorder cognitive behavioral therapy (CBT) approaches (either AUD-focused or SAD-focused), treatment efficacy and long-term outcomes are negatively impacted by the co-occurring disorders. Two alternate treatment models have been tested for co-occurring SAD-AUD: (i) dual-focused treatment, and (ii) integrated treatment. In one of two trials, dual-focused CBT for SAD and AUD resulted in worse outcomes, potentially due to the demands of engaging in two separate treatments. By contrast, integrated SAD-AUD treatment involves a synthesized therapeutic protocol (delivered by one therapist) to address SAD, AUD and the inter-connection between these disorders. To date, two trials have found that integrated CBT for co-occurring SAD-AUD improved outcomes compared to AUD-focused treatment. The remainder of the chapter provides a comprehensive overview of the therapeutic strategies and clinical application of integrated CBT for co-occurring SAD and AUD. A clinical vignette illustrates the treatment, common challenges, and provides example worksheets and therapeutic dialogue.

Introduction Barriers to help‐seeking for illicit drug use cross psychosocial (e.g., knowledge of where to seek help, attitudinal beliefs like being afraid of what people will think) and structural (e.g., service availability) domains. Along with people who use illicit drugs, it is important to consider the perspectives of other key groups who are often involved in the help‐seeking and recovery process. This study aimed to examine the perceived barriers to help‐seeking for people who use crystal methamphetamine (‘ice’) among key groups (people who use crystal methamphetamine, families and friends, health workers) as well as the general community. Methods A cross‐sectional online survey open to all Australian residents (aged ≥18 years) was conducted November 2018–March 2019. Four key groups of interest were recruited to examine and compare perceived barriers to help‐seeking for crystal methamphetamine use. Results Participants ( n = 2108) included: people who use/have used crystal methamphetamine ( n = 564, 39%), health workers ( n = 288, 26.8%), affected family/friends ( n = 434, 13.7%) and general community ( n = 822, 20.6%). People who used crystal methamphetamine demonstrated increased odds of reporting attitudinal (OR 1.35; 1.02–1.80) or structural (OR 1.89; 1.09–3.27) barriers, or a previous negative help‐seeking experience (OR 2.27; 1.41–3.66) compared to knowledge barriers. Health workers demonstrated decreased odds of reporting attitudinal compared to knowledge barriers (OR 0.69; 0.50–0.95). Discussion and Conclusions Perceived barriers to seeking help for crystal methamphetamine use differed among key groups involved in treatment and recovery. Acknowledging and addressing the mismatches between key groups, through targeted interventions may better support people to seek help for crystal methamphetamine use.

Issue Addressed Substance use and mental illness remain critical issues for young Australians, however, engagement with evidence‐based health resources is challenging among this age group. This study aimed to develop engaging, useful digital health resources, underpinned by neuroscience principles, to build awareness of the harms of electronic cigarettes (e‐cigarettes) and concurrent alcohol and antidepressant use. Methods A mixed‐methods approach was adopted to co‐design two evidence‐based videos resources. The resources were co‐designed with the Matilda Centre's Youth Advisory Board Centre's Youth Advisory Board through a series focus groups and individual feedback reviews. Young people residing in New South Wales were then invited to complete a survey to evaluate the usefulness, relatability and impact on perceived harms associated with each substance pre‐ and post‐viewing resources. Results A total of 100 participants completed the survey (mean age = 21.5 years, SD = 2.77, 42% Female, 2% Non‐binary). The animated videos were well received, with the large majority (91% and 87% respectively) of participants rating them ‘excellent’ or ‘very good’. After viewing the videos, there was a significant increase in the perception of harm associated with e‐cigarette use, monthly (t(99) = 2.76, p = .003), weekly (t(99) = 4.82, p < .001) and daily (t(99) = 4.92, p < .001), and consuming alcohol whilst taking antidepressants both weekly (t(100) = 2.93, p = .004) and daily (t(100) = 3.13, p = .002). Conclusions This study describes a successful co‐design process demonstrating how meaningful involvement of young people, alongside traditional research methods, can produce substance use prevention resources that are useful, engaging and increase knowledge of harms among young people. So What? To achieve meaningful public health impact researchers, experts and digital creators can work together to co‐create substance use educational materials that are engaging, well‐liked, while imparting important health knowledge.

The Metacognitions Questionnaire – Short Form (MCQ-30) was designed as a parsimonious measure of the metacognitive beliefs and processes implicated in the maintenance of Generalized Anxiety Disorder (GAD). The present study sought to examine the psychometric properties and clinical utility of the MCQ-30 among people with GAD. One hundred and thirty-nine adults diagnosed with GAD and 76 non-clinical controls completed the MCQ-30 and self-report measures of worry, fear of anxiety, attempted thought suppression, distress, GAD symptoms, and interference. A five-factor structure was evaluated using confirmatory factor analysis (CFA). Among the clinical sample, CFA supported the construct validity of the scale, although the relationship between the factors differed from community samples. Evidence was found for the internal consistency, test-retest reliability, and concurrent, convergent and criterion validity of the MCQ-30 in people with GAD. The treatment sensitivity and clinical responsiveness of the scale were also demonstrated, with the Uncontrollability and Danger Beliefs subscale identified as the most accurate predictor of clinical status. This subscale also exhibited the strongest correlations with most symptom measures, highlighting the cardinal role played by negative beliefs about worry in maintaining clinical levels of GAD. This study provides the first evidence of the reliability, validity and clinical utility of the MCQ-30 with people diagnosed with GAD.

Background and aims Alcohol use and anxiety often co‐occur, causing increased severity impairment. This protocol describes a randomized controlled trial (RCT) that aims to test the efficacy and cost‐effectiveness of a web‐based, self‐guided alcohol and anxiety‐focused program, compared with a web‐based brief alcohol‐focused program, for young adults who drink at hazardous levels and experience anxiety. It will also test moderators and mechanisms of change underlying the intervention effects. Design This RCT will be conducted with a 1:1 parallel group. Setting The study will be a web‐based trial in Australia. Participants Individuals aged 17–30 years who drink alcohol at hazardous or greater levels and experience at least mild anxiety ( n = 500) will be recruited through social media, media (TV, print) and community networks. Intervention and comparator Participants will be randomly allocated to receive a web‐based, integrated alcohol‐anxiety program plus technical and motivational telephone/e‐mail support (intervention) or a web‐based brief alcohol‐feedback program (control). Measurements Clinical measures will be assessed at baseline, post‐intervention (2 months), 6 months (primary end‐point), 12 months and 18 months. Co‐primary outcomes are hazardous alcohol consumption and anxiety symptom severity. Secondary outcomes are binge‐drinking frequency; alcohol‐related consequences; depression symptoms; clinical diagnoses of alcohol use or anxiety disorder (at 6 months post‐intervention), health‐care service use, educational and employment outcomes; and quality of life. Mediators and moderators will also be assessed. Efficacy will be tested using mixed models for repeated measures within an intention‐to‐treat framework. The economic evaluation will analyze individual‐level health and societal costs and outcomes of participants between each trial arm, while mediation models will test for mechanisms of change. Comments This will be the first trial to test whether a developmentally targeted, web‐based, integrated alcohol‐anxiety intervention is effective in reducing hazardous alcohol use and anxiety severity among young adults. If successful, the integrated alcohol‐anxiety program will provide an accessible intervention that can be widely disseminated to improve wellbeing of young adults, at minimal cost.