Browsing by Author "Beshai, Shadi"

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Open Access
Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel
(BMC, 2022-12-09) Carleton, R. Nicholas; McCarron, Michelle; Krätzig, Gregory P.; Sauer-Zavala, Shannon; Neary, J. Patrick; Lix, Lisa M.; Fletcher, Amber J.; Camp, Ronald D.; Shields, Robyn, E.; Jamshidi, Laleh; Nisbet, Jolan; Maguire, Kirby Q.; MacPhee, Renée, S.; Afifi, Tracie O.; Jones, Nicholas A.; Martin, Ronald, R.; Sareen, Jitender; Brunet, Alain; Beshai, Shadi; Anderson, Gregory S.; Cramm, Heidi; MacDermid, Joy C.; Ricciardelli, Rosemary; Rabbani, Rasheda; Teckchandani, Taylor A.; Asmundson, Gordon J.G.
Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder.
Open Access
Burnout and Mental Well-Being in Higher Education: Investigating the Impact of Multicultural Efficacy
(Faculty of Graduate Studies and Research, University of Regina, 2019-08) Chahar Mahali, Saghar; Beshai, Shadi; Gordon, Jennifer; Sevigny, Phillip; McGinnis, Angela
Canadian universities are experiencing a dramatic increase in the enrollment of students from diverse backgrounds. Many educators are not prepared to teach in multicultural contexts. Educators’ lack of preparedness to teach in such contexts may lead them to develop burnout, which can negatively impact their mental and professional well-being. However, self-efficacy beliefs (i.e., judgements of personal capabilities in executing a specific task successfully) may buffer against job burnout and promote mental wellbeing. Hence, multicultural efficacy, defined as the confidence to teach diverse students effectively, is an important factor for teaching in multicultural settings. Limited studies have investigated the impact of colour-blind racial attitudes on university instructors’ multicultural efficacy and the potential role of multicultural efficacy on their burnout and mental well-being. The purpose of this study was to examine the link between multicultural efficacy and colour-blind racial attitudes, and the impact of multicultural efficacy on instructors’ burnout and mental well-being, after controlling for demographics, job-related characteristics, teaching self-efficacy, and colour-blind racial attitudes. One hundred and fifty-eight faculty and sessional instructors at the University of Regina and its federated colleges as well as the Universities of Saskatchewan, Alberta, and British Colombia participated in this study. The results revealed that multicultural efficacy was negatively related to colour-blind racial attitudes. Furthermore, multicultural efficacy was identified as a significant and positive predictor of Personal Accomplishment facet of burnout and mental well-being. Higher scores on Personal Accomplishment dimension are indicative of lower levels of burnout. These findings can inform the development of training opportunities and diversity-related workshops to enhance instructors’ awareness of diversity, social justice issues, and multicultural efficacy to better equip them for instruction in multicultural classrooms.
Open Access
Contextual Influences in Decoding Pain Expressions: Effects of Patient Age, Informational Priming, and Observer Characteristics
(Faculty of Graduate Studies and Research, University of Regina, 2018-01) Hampton, Amy Jean Diane Hampton; Hadjistavropoulos, Thomas; Beshai, Shadi; Asmundson, Gordon; Urban, Ann-Marie; Jackson, Philip
According to clinical and experimental research, nonverbal expressions of pain are key components in its assessment. Theoretical formulations of pain specify that various contextual influences, or factors unrelated to the pain experience (e.g., patients’ age), significantly moderate observers’ interpretation of nonverbal pain expressions. Such contextual factors have been found to alter observers’ assessment of younger adults’ pain; however, the systematic study of such influences within the context of the older adult has been limited. The purpose of this study was to examine the effects of contextual factors on decoding facial pain expressions in both younger and older adults. A total of 165 participants (82 nursing students and 83 non-nursing students) were recruited. Participants were randomly assigned to one of three priming conditions: (1) information about the possibility of secondary gain [misuse]; (2) information about the frequency and undertreatment of pain in the older adult [undertreament]; or (3) neutral information [control]. Subsequently, participants viewed eight videos of older adults and eight videos of younger adults expressing pain nonverbally. Following each video, participants rated their perception of the individual’s pain intensity, unpleasantness, and condition severity as well as their willingness to help and sympathy, patient deservingness of financial compensation, and how negatively/positively they feel towards the individual (i.e., valence). Mixedmodel analyses were conducted to determine the main effects and interactions across prime conditions (misuse vs. undertreatment vs. control), observer type (nursing and non-nursing students), and stimulus persons’ age (older vs. younger stimulus persons) on observers’ estimates. Results demonstrated that observers’ ratings varied as a function of stimulus persons’ age, observer type, and informational priming condition. More specifically, observers ascribed greater levels of pain and rated differently (e.g., greater sympathy) older stimulus persons compared to younger. Observer type and stimulus persons’ age also interacted to influence observers’ ratings. That is, in comparison to nonnursing students’ ratings of younger adults, nursing student endorsed higher ratings of younger adults’ pain and compensation deservingness. Additionally, priming conditions interacted with both observer type and stimulus persons’ age to moderate observers’ valence towards the stimulus person. In general, this interaction demonstrated that observers primed with information about the undertreatment of pain in older persons reported more positive valence towards older patients and priming observers with information about the misuse of the health care system attenuated their valence ratings towards younger patients. Finally, the undertreatment of pain in older adults prime also influenced observers’ pain estimates indirectly though observers’ valence towards the stimulus persons. More specifically, observers in the undertreatment prime condition reported more positive valence towards stimulus persons. The higher valence subsequently resulted in higher ratings of pain and affected other ratings (e.g., willingness to help) of both younger and older patients. In summary, results support the influence of contextual features in interpreting others’ pain. Findings from this study add specificity to the theoretical formulations of pain by clarifying the role of several contextual factors on observers’ interpretations of nonverbal pain expressions of older and younger persons.
Open Access
Cross-Cultural Examination of the Cognitive Theory of Depression Among Individuals of Chinese and Canadian Descent
(Faculty of Graduate Studies and Research, University of Regina, 2018-09) Yu, Kwan Tsz; Beshai, Shadi; Carleton, R. Nicholas; Hadjistavropoulos, Heather; Camp, Ronald
Major Depressive Disorder (MDD) or major depression is a debilitating condition affecting members of all cultures around the world. The cognitive theory of depression is one of the most researched theories of the disorder worldwide; however, the theory’s cross-cultural applicability has not been extensively studied, especially among Chinese participants. According to the cognitive theory of depression, symptoms of major depression are hypothesized to strongly associate with negatively distorted cognitions about the self, world, and future. The present investigation examined five descriptive hypotheses (e.g., negativity hypothesis, exclusivity hypothesis, severity/persistence hypothesis, schema activation hypothesis, and selective processing hypothesis) derived from the cognitive theory of depression in a Canadian and a Chinese sample of dysphoric and non-dysphoria individuals to evaluate the theory’s cross-national validity. Dysphoria is conceptualized as a complex emotional state characterized by intense unhappiness and irritability. Data from 259 participants (129 dysphoric and 32 non-dysphoric Canadians; 18 dysphoric and 18 non-dysphoric Chinese) were analyzed to examine the five descriptive hypotheses. Participants completed a battery of self-report measures (i.e., Patient Health Questionnaire [PHQ-9], The Center for Epidemiologic Studies– Depression Scale [CES-D], Automatic Thoughts Questionnaire–Negative [ATQ-N], Automatic Thoughts Questionnaire–Positive [ATQ-P], and Dysfunctional Attitudes Scale [DAS-24]) and a facial expression recognition task. Dysphoric participants in both countries exhibited significantly more negative self-referent cognitions and dysfunctional attitudes, but significantly less positive self-referent cognitions than their non-dysphoric counterparts. Further, negative and positive self-referent cognitions, and dysfunctional attitudes were correlated with depressive symptoms among the Canadian sample. With the exception of the correlation between dysfunctional attitudes and depressive symptoms, negative and positive self-referent cognitions were significantly and meaningfully correlated with depressive symptoms among Chinese participants. Additionally, there was a trend showing that dysphoric participants in both countries demonstrated higher recall for sad faces in comparison to their non-dysphoric counterparts. Taken together, the current results support the cross-national validity of five descriptive hypotheses of the cognitive theory of depression among individuals of Canadian and Chinese descent and the findings may have clinical implications in the treatment of major depression among non-Western populations.
Open Access
Differences in psychological outcomes associated with institutional betrayal
(Faculty of Graduate Studies and Research, University of Regina, 2022-09) Avey, Milo Phoenix; Klest, Bridget; Beshai, Shadi; Gallant, Natasha; Flood, Dawn
Institutional betrayal occurs when institutions fail to effectively support or protect the individuals who rely on them (Smith & Freyd, 2013). Institutional betrayal often happens after an adverse or traumatic event such as a sexual assault (Smith & Freyd, 2013). Previous research has found that institutional betrayal can result in worse mental and physical health outcomes following adverse experiences, even when the adverse experience is controlled for (Smith & Freyd, 2013). The purpose of this study was to investigate if differences in psychological outcomes exist for institutional betrayal following different types of adverse experiences, including racism, adverse medical experiences, and student sexual assault. Several hypotheses were posited. A total sample of 147 participants was collected with a relatively even split between groups (racism n = 34; adverse medical experiences n = 42; sexual assault n = 49; control n = 22). Participants were presented with an online questionnaire that asked about their adverse experiences and measured common psychological outcomes including anxiety, depression, and PTSD symptoms. Participants were separated into groups based on their adverse experiences and asked to complete a measure of institutional betrayal. Significant differences between groups on all symptom measures were found using one-way ANOVAs, and post hoc multiple comparisons revealed that the sexual assault group scored highest on all symptom measures. Regression analyses showed that demographic factors significantly predicted symptoms, and the addition of adverse experiences significantly improved the prediction of psychological symptoms. Results regarding institutional betrayal were mixed, showing that by itself, institutional betrayal significantly predicted PTSD symptoms, but did not predict anxiety symptoms. The addition of institutional betrayal to demographic factors and adverse experiences did not significantly add to the predictive power of the model, suggesting that it may have less of an impact on psychological symptoms than demographics and experiences. No moderation effects were found between institutional betrayal and adverse experiences. Implications, limitations, and future directions are discussed.
Open Access
Does Exercise Prevent Exacerbation of Anxiety-Related Vulnerability Factors Following An Analogue Stressor: A Randomized Controlled Trial
(Faculty of Graduate Studies and Research, University of Regina, 2019-12) Krakauer, Rachel Lauren; Asmundson, Gordon J.G.; Carleton, R. Nicholas; Beshai, Shadi; Watt, Margo C.
The most common mental disorders are anxiety-related disorders (Andlin-Sobocki & Wittchen, 2005). The diathesis-stress model of psychopathology explains that stressors interact with vulnerability factors to influence the development of anxiety-related disorders (Monroe & Simmons, 1991); therefore, modifying vulnerability factors before a stressor occurs may reduce or prevent anxiety. Researchers have observed significant reductions in anxiety-related vulnerability factors following as little as a single session of exercise (Asmundson et al., 2013), suggesting exercise effectively targets vulnerability factors. Research is needed to investigate whether exercise interventions implemented prior to a stressful event can target anxiety-related vulnerability factors, thereby protecting against future anxiety or distress. The current randomized controlled trial assessed whether exercise could prevent elevations in measures of anxiety-related vulnerability factors following a stressful exposure. A nonclinical sample of community adults was randomly assigned to complete a 30-minute exercise protocol on a stationary bike (experimental condition) or lightly stretch for 30 minutes (placebo control condition). All participants subsequently watched a traumatic film clip used as an analogue stressor. Participants completed measures of anxiety-related vulnerability factors—state and trait anxiety, anxiety sensitivity (AS), distress tolerance (DT), and intolerance of uncertainty (IU)—at baseline, after exercise, after the analogue stressor, and at 3-day and 7-day follow-ups. Participants in the experimental group did not report statistically significantly lower scores on measures of vulnerability factors compared to the placebo control group. Overall, vulnerability factor scores were relatively stable across time. Effects of time were observed, demonstrating anxiolytic effects of physical activity that protected both groups against elevations in putative anxiety-related vulnerability factors. The results offer initial support for the efficacy of both exercise and stretching control to prevent elevations in AS, IU, state anxiety, trait anxiety, and reductions in DT, although analyses may have been underpowered. The current trial offers practical implications for individuals who regularly experience potentially traumatic events, as well as community adults who deal with minor daily stressors.
Open Access
Efficacy of a brief online mindfulness and self-compassion intervention (Mind-OP+) to increase connectedness: Randomized controlled trial
(Faculty of Graduate Studies and Research, University of Regina, 2023-07) Bueno, Christine Frances Bast; Beshai, Shadi; Hadjistavropoulos, Heather; Sharpe, Donald; O'Rourke, Hannah
Connectedness is defined as a connection with others that promotes well-being. Although studies examining connectedness are few to date, the extant literature on closely related concepts suggests connectedness is associated with reduced symptoms of psychological and physical disorders and higher overall well-being. Cultivating feelings of connectedness also appears to encourage prosocial behaviour, such as volunteering or donating to charity. Mindfulness and compassion interventions (MBIs) may be adapted to cultivate feelings of connectedness, thereby unlocking a protective mechanism in mental health and beyond. Further, brief self-guided MBIs are particularly promising, given demonstrations of their efficacy combined with their potential for wide scalability and dissemination. Accordingly, this author examined the effectiveness of an augmented, self-guided, brief, online mindfulness and self-compassion-based intervention (Mind-OP+) to facilitate perceptions of connectedness in undergraduate students. Total of 117 undergraduate students were randomized into a waitlist (n = 55) or Mind-OP+ (n = 62) condition. Participants in the Mind-OP+ condition completed five modules at a pace of one module per week. Correlation analyses with participants that passed baseline attention-checks (n = 101 ) revealed that social connectedness at baseline was correlated positively with mindfulness and self-compassion, and correlated negatively with fears of compassion, depression, anxiety, and stress. Relatedness at baseline was correlated positively with mindfulness and negatively with fears of compassion and depression, stress, and anxiety. Intent-to-treat mixed-model analyses on all randomized participants indicated that, compared to participants in the waitlist condition, participants in Mind-OP+ reported increased feelings of social connectedness (d = 0.81) and relatedness (d = 0.64) at post-treatment, and increased feelings of social connectedness (d = 0.80) and relatedness (d = .38) at one-month follow-up. Mediation analyses completed with protocol adherent participants at post-treatment (n = 47) demonstrated no statistically significant mediation of self-compassion or mindfulness scores on the relationship between group membership and connectedness nor relatedness scores at post-treatment. These findings provide support for the use of brief, accessible, self-guided interventions to cultivate connectedness. Larger, more definitive trials should compare the effects of Mind-OP+ for connectedness against an active control, and examine whether the effects on connectedness are independent of effects of reducing psychological disorder symptoms. This intervention holds promise as an option for those seeking protective factors for their mental health and general resiliency.
Open Access
Efficacy of an Internet-delivered self-compassion intervention in preventing depressive relapse and recurrence: A randomized controlled trial in a clinical sample
(Faculty of Graduate Studies and Research, University of Regina, 2023-12) Yu, Kwan Tsz; Beshai, Shadi; Asmundson, Gordon; Hadjistavropoulos, Heather; Martin, Ronald; Dozois, David J.A.
Depression is a prevalent and burdensome mental health condition. Unfortunately, depression is chronic and recurrent, with a lifetime average of four to five episodes. Although evidence supports the efficacy of self-compassion interventions for a range of psychological disorders (Ferrari et al., 2019), research on scalable forms of compassion-based interventions for recurrent depression remains scarce. The primary purpose of this two-arm randomized controlled trial (RCT) was to examine the efficacy of a 6-week internet-delivered, self-directed self-compassion intervention in preventing depressive relapse and recurrence over a 12-month period in a clinical sample of adults with a history of depression. The efficacy of the intervention was tested against a self-reflection active control condition. In addition to examining differential relapse/recurrence rates, the RCT compared changes in the primary outcome of depressive symptoms (PHQ-9), and secondary outcomes of self-compassion (SCS), mindfulness (FFMQ-15), decentering (EQ-D), and fear of self-compassion (FCSS) across conditions and time. A total of 158 participants meeting eligibility criteria (87% identifying female; M number of prior depressive episodes = 2.88 [SD = 1.82]) were randomized into the self-compassion (SC; n = 80) intervention condition or self-reflection (SR; n = 78) active control condition. All participants completed primary and secondary outcome measures at baseline, weekly throughout the 6-week intervention period, at post-treatment, and at each of four followups (at 3-, 6-, 9-, and 12-month post-randomization). Participants also completed a phone interview at each follow-up to determine relapse/recurrence status. Depressive episodes were assessed by a structured interview. Kaplan-Meier survival analyses were conducted to compare rates of depressive relapse/recurrence between the two conditions across the trial period. Cox proportional hazards regression analyses were conducted to examine the effects of predictors on time until relapse/recurrence. Multilevel modeling and mixed model analysis of variance were conducted to examine differential changes in primary and secondary outcomes between the two conditions. Contrary to primary hypotheses, survival analysis revealed no significant differences in relapse/recurrence rates between SC participants (relapse rate = 33%) and SR participants (relapse rate = 43%) across the 12-months trial period, χ2(1) = .35, p = .56. Number of past depressive episodes and baseline fear of self-compassion predicted time until relapse/recurrence in an exploratory survival analysis; greater number of past episodes and higher levels of fear of self-compassion were associated with a higher likelihood of relapse. Further, SC participants did not report significantly greater reductions in depressive symptoms, nor significantly greater increases in mindfulness and decentering compared to SR participants. However, SC participants reported significantly greater increases in self-compassion and significantly greater decreases in fear of self-compassion compared to SR participants across the trial period. Results revealed a main effect of time on all outcome measures; participants in both conditions reported significantly lower distress across time. The current findings support self-directed self-compassion training as a feasible approach to cultivating protective and reducing risk factors associated with recurrent depression. Self-compassion training through an internet-delivered self-directed program may be appropriate for use as an adjunct to more established evidence-based treatments specifically targeting relapse in depression. Keywords: recurrent depression, relapse/recurrence, self-compassion, mindfulness, decentering, fear of self-compassion, compassion-based intervention, RCT
Open Access
Efficacy of Internet-Delivered Cognitive Behavioural Therapy Following An Acute Coronary Event: A Randomized Controlled Trial
(Faculty of Graduate Studies and Research, University of Regina, 2019-08) Schneider, Luke Hameluck; Hadjistavropoulos, Heather; Carleton, Nicholas; Beshai, Shadi; Neary, Patrick; Linden, Wolfgang
Depression and anxiety are common among people who have experienced an acute coronary event (e.g., heart attack). Multidisciplinary cardiac rehabilitation programs often focus on reducing risk factors associated with future cardiac events (e.g., smoking, lipid management), however, mental health interventions are not routinely available following significant coronary events. The present study sought to explore the efficacy and acceptability of an Internet-delivered cognitive behavioural therapy program (Cardiac Wellbeing Course) for managing depression and anxiety symptoms among participants who experienced an acute coronary event. Participants were randomized to an intervention (n = 25) or waiting-list control group (n = 28). Symptoms were assessed at pre-treatment, post-treatment, and four-week follow-up, with only 12% of participants not providing follow-up data. Statistically significant within-group improvements were observed for the treatment group on primary measures of depression (d = 1.97; 61% reduction) and anxiety (d = 1.75; 67% reduction). Statistically significant improvements were also observed on secondary measures of distress (d = 1.70; 51% reduction), heartfocused anxiety (d = 1.24; 34% reduction), activity levels (d = 0.73; 70% reduction), and mental-health quality of life (d = 1.27; 24% improvement). Improvements in physical health quality of life were not statistically different between groups. The changes observed were maintained at 4-week follow-up and satisfaction rates were high among intervention participants (95%). The current findings add to the existing literature and highlight the specific potential of Internet-delivered cognitive behavioural therapy programs among participants who have experienced an acute coronary event.
Open Access
Examining Change in Health Anxiety Symptoms Resulting From Transdiagnostic, Internet-Delivered Cognitive Behaviour Theapy: The Impact of Therapist Support
(Faculty of Graduate Studies and Research, University of Regina, 2017-08) Owens, Victoria Ayla Mary; Hadjistavropoulos, Heather; Carleton, Nick; Beshai, Shadi; Hoeber, Larena; Katapally, Tarun
Internet-delivered Cognitive Behaviour Therapy (ICBT) is a relatively new method to improve access to psychological services and is based on the principles of cognitive behaviour therapy (CBT), a well-established and efficacious treatment option for various mental health concerns. The presence of therapist support is regarded as an important element in ICBT, yet less is known about how much therapist contact is needed; namely, whether optional therapist contact is as effective as weekly communication with a therapist. ICBT programs have historically been disorder-specific in nature, wherein specific information relevant to one disorder is presented; disorder-specific ICBT is efficacious in the treatment of generalized anxiety, panic, social phobia, depression, and health anxiety. Alternatively, transdiagnostic ICBT does not target one specific disorder, rather broad areas observable across different mental health disorders, which results in administering the same treatment protocol to individuals regardless of their primary diagnosis. Transdiagnostic ICBT has effectively reduced symptoms of depression, generalized anxiety, social phobia, and panic. The current study examined whether transdiagnostic ICBT can effectively reduce symptoms of health anxiety, characterized by excessive worry about one’s health and fear that one will acquire an illness, often resulting in frequent medical consultations at a significant economic cost. Further, the impact of level of therapist support (therapist-initiated vs. client-initiated) was investigated. Ninety-six clients participating in the Wellbeing Course, an 8-week transdiagnostic ICBT program, with elevated health anxiety symptomatology (≥15 on the Short Health Anxiety Inventory [SHAI]) were randomly assigned to a therapist-initiated (n = 52; consistent, weekly messages from therapist) or client-initiated (n = 44; message received from therapist only when client initiates communication) contact condition. Health anxiety symptoms decreased significantly from pre-treatment to post-treatment (χ2 = 25.05, p < 0.001), lending support to the efficacy of transdiagnostic ICBT in the treatment of health anxiety. Pertinently, the level of therapist support (therapist-initiated vs. client-initiated) did not appear to impact symptom reduction. Client-initiated contact requires less therapist time, which allows for higher levels of efficiency, as support is provided on an as-needed level. The level of therapist support did not directly impact symptom reduction, yet consistent and weekly messages from a therapist did promote more favourable treatment engagement when compared to optional therapist communication (4.48 vs. 3.86 lessons completed; 4.21 vs. 1.77 messages sent) and was associated with higher treatment completion rates (76.9% vs. 54.5%). Future research is warranted to disentangle the role of therapist contact on symptom reduction and treatment engagement. The current study did not identify significant predictors of health anxiety reduction; future research should further investigate whether ICBT is better suited for certain individuals. The results from the current study lend support for the use of transdiagnostic ICBT in the treatment of health anxiety; thus improving individual wellbeing and lessening the burden placed on the healthcare system.
Open Access
Examining Motivational Interviewing and Booster Sessions in Internet-Delivered Cognitive Behaviour Therapy for Post- Secondary Students: An Implementation Trial
(Faculty of Graduate Studies and Research, University of Regina, 2022-01) Peyenburg, Vanessa Angelica; Hadjistavropoulos, Heather; Beshai, Shadi; Wright, Kristi; Hébert, Cristyne; Alavi, Nazanin
Approximately one in three post-secondary students experience clinical levels of anxiety or depression during their academic career, with many students not receiving treatment. Internet-delivered cognitive behaviour therapy (ICBT) is an alternative to face-to-face services that is effective in general adult populations, but has been associated with high attrition rates and smaller effect sizes in student populations. In this implementation trial, the efficacy and uptake of an ICBT course for anxiety and depression (i.e. the UniWellbeing Course) was examined in Saskatchewan. Given the evidence from the face-to-face literature, the role of motivational interviewing (MI) and booster lessons was also examined. Using a two-factor design (factor 1: online MI); factor 2: booster lesson), a total of 308 clients were randomized to one of four groups: standard care (n = 78), MI (n = 76), booster (n = 77), and MI + booster (n = 77). Overall, 89.9% (n = 277) of clients started treatment. The aims of the study were to assess (1) the efficacy of the UniWellbeing Course in reducing symptoms of anxiety and depression and increasing perceived academic functioning; (2) the impact of a pre-treatment MI component on attrition and engagement; (3) the impact of a booster lesson on depression, anxiety, and perceived academic functioning at 3-month follow-up; and (4) the combined effect of MI and booster. Overall, students reported significant, large decreases in symptoms of depression (Cohen’s d: 1.25 – 1.67) and anxiety (Cohen’s d: 1.42 – 2.01) from pretreatment to post-treatment, with 47.5% and 56.6% of clients experiencing reliable recovery on measures of depression and anxiety, respectively. Small, but significant, effects were seen for improvements in perceived academic functioning across the four conditions (Cohen’s d: 0.20 – 0.48). Changes were maintained at 1-month and 3-month ii follow-up on all primary measures across conditions. Overall, 54.0% (n = 150) of clients accessed all four lessons of the UniWellbeing Course. The addition of pre-treatment MI did not confer improvements to treatment completion rates or engagement (e.g., mean logins or messages sent to therapists). Small between-group effects were seen in favour of MI for depression (Cohen’s d: 0.23), anxiety (Cohen’s d: 0.25), and mental healthrelated disability (between-group Cohen’s d: 0.35) at post-treatment. In terms of the booster lesson, only 30.9% (n = 43) of clients accessed the booster lesson, although clients who accessed it were satisfied with the content and timing of the booster overall. Between-group effects were not significant for the booster at 3-month follow-up. Subanalyses comparing clients who utilized the booster to those who did not were underpowered, but revealed a larger decrease in depressive symptoms (between-group Cohen’s d: 0.31) at 3-month follow-up. No advantage was found for the combination of MI and booster on treatment completion, engagement, or outcomes. Overall, there is some evidence to suggest that including MI at pre-treatment results in greater symptom reduction although these benefits do not persist to 1-month and 3-month follow-up. The inclusion of a self-guided booster lesson may also help with continued symptom management up to 3-month follow-up, but low uptake is a barrier to clients experiencing these benefits. Uptake of the course was highest among White female participants and at large universities, suggesting a need for alternative recruitment strategies to increase uptake among other student populations. Findings from this trial contribute to the literature on improving ICBT outcomes for post-secondary students.
Open Access
Experimentally Testing the Tree-Factor Structure of Socio-Emotional Comparisons
(Faculty of Graduate Studies and Research, University of Regina, 2019-12) Refaie, Nabhan; Beshai, Shadi; Mishra, Sandeep; Oriet, Chris; Smith, Heather
Evolutionary theories posit that comparisons to others are essential in determining one’s relative position in a social hierarchy. Social comparison information can help guide behaviour in several ways, but has been associated with different adverse psychological issues (e.g., depression; stress). However, a purely cognitive view of social comparisons ignores the emotional content that usually accompanies them. A novel construct named socioemotional comparisons (SEC) is theorized to bridge the cognitionemotion gap. SEC is defined as experiences of negative affect following a subjective evaluation of unfair or unjust disadvantage compared to another. These comparisons are represented by three factors: malicious envy, low self-esteem, and justice sensitivity. No study, however, has examined SEC’s proposed three-factor structure. In addition, the intercorrelation of SEC’s factors should not be better explained by confounding variables such as the experience of negative affect. This research attempted to validate the SEC construct through a series of experiments. I conducted three experiments, each manipulating a separate SEC factor. I then examined how experimental manipulations changed SEC scores, and whether these changes remained once negative affect was controlled for. Results showed that experimental manipulations of malicious envy did not significantly change SEC total or factor scores. Manipulations of self-esteem and justice sensitivity significantly changed SEC total and factor scores. However, once negative affect was controlled for, these effects disappeared. In light of these results, the nature and definition of the SEC construct, limitations of the present study, clinical and theoretical implications, and directions for future research are discussed.
Open Access
From the Distal to the Proximate: Exploring Social Cognitions in Risk-taking
(Faculty of Graduate Studies and Research, University of Regina, 2019-09) Wuth, Amanda Alexandra; Beshai, Shadi; Mishra, Sandeep; Wright, Kristi; Volk, Tony
Risk-sensitivity theory suggests people engage in risk-taking when they cannot fulfill needs through risk-averse behavior. Both proximate mechanisms (e.g., affect, social cognition) and distal mechanisms (e.g., early developmental environments) have been shown to influence risk-taking. However, little is understood about how such mechanisms contribute to the perception of benefits derived from risk-taking. A pilot study (n = 172) and follow-up confirmatory study (n = 295) were conducted to identify which proximate and distal mechanisms were associated with the perception of increased benefits from risk-taking. I specifically examined if benefit perceptions of risk-taking were associated with distal, developmental inputs (early environmental harshness and unpredictability, life history orientation) and more proximate dispositional and situational factors (cognitive distortions, locus of control, self-efficacy, negative socioemotional comparisons, dispositional envy). Five questions were addressed by the study. First, do social cognitions load onto a single factor? A confirmatory factor analysis indicated negative socioemotional comparisons (NSECS), cognitive distortions (CDS) and external locus of control (c.LOC; p.LOC) loaded onto a single factor. Model fit was improved through allowing the external locus of control subscales to covary. (2) How are distal mechanisms and social cognitions associated? Zero-sum correlations indicated cognitive distortions and negative socioemotional comparisons were consistently associated with early environmental harshness and unpredictability (rs = .12 to .31, ps < .05). Hierarchical multiple regressions also indicated that early environmental harshness and unpredictability account for significant incremental change in negative socioemotional comparison tendencies and dispositional envy propensity, F(12, 271) = 6.96, p < .001, R2 = .24 and F(12, 271) = 4.23, p <.001, R2 = .16, respectively. (3) How are distal mechanisms and risk-taking associated? Zero-sum correlations indicated benefit perceptions of risk-taking was associated with adverse childhood experiences (r = .31, p < .001). General risk attitudes were associated with all early environmental conditions (rs = .13 to .23, ps <.05). Hierarchical multiple regressions also indicated that early environmental harshness and unpredictability account for significant incremental change in benefit perceptions of risk-taking and risk attitudes, F(12, 271) = 9.04, p < .001, R2 = .29 and F(12, 271) = 5.27, p < .001, R2 = .19, respectively. (4) How are social cognitions and risk-taking associated? Zero-sum correlations indicated benefit perceptions of risk-taking was associated with all measured social cognitions (r = .16 to .35, p < .001). General risk attitudes were also associated with external locus of control (rs = .13 to .14, ps < .05), but not negative socioemotional comparisons nor cognitive distortions. (5) Do social cognitions mediate associations between distal mechanisms and risk-taking? Four path analysis models were tested to identify how social cognitions may mediate associations between distal mechanisms and benefit perceptions of risk-taking. Each model demonstrated some measure of good fit, but no model was determined to generate an adequate model fit across multiple measures. This study is one of the first empirical examinations of benefit perceptions of risk, and is the first attempt to model the relationships between benefit perceptions of risk and antecedent proximal and distal variables.
Open Access
The Impact of Cognitive Distortions on Negative Social Comparisons and Depressive Symptoms: Six-Month Longitudinal Study
(Faculty of Graduate Studies and Research, University of Regina, 2019-08) Iskric, Adam Joseph; Beshai, Shadi; Hadjistavropoulos, Heather; Mishra, Sandeep; Fletcher, Kara
Depression is a debilitating mental disorder associated with impairment in social, family, and educational functioning, along with higher rates of comorbid anxiety disorders, poorer physical health, and a decrease in overall quality of life. The predictive cognitive model of depression states that negative cognitions may increase the risk of developing depression. However, there remains a lack of longitudinal studies examining whether baseline negative cognitions predict follow-up levels of depression. Consistent with the cognitive theory of depression, biased interpretations of the external world may be associated with increased negative social comparisons among individuals with a vulnerability to depression, which may in turn exacerbate depressive symptoms. The concept of negative social comparisons has recently been expanded to include feelings of anger, envy, and resentment towards others, negative evaluative thoughts about the self, and beliefs about distributive injustice, collectively known as socio-emotional comparisons. There is a paucity of research on whether socio-emotional comparisons are a consequence of, or a cause of, depressive symptoms, and whether social comparisons are linked with negative cognitive processes (e.g., cognitive distortions) known to exacerbate depression. In this six-month longitudinal study, I investigated the relationships among cognitive distortions, socio-emotional comparisons, and depressive symptoms. Participants were recruited online, using the crowdsourcing platform Amazon’s Mechanical Turk. A total of 644, 468, and 391 participants were recruited at baseline, three months, and six months, respectively. All participants completed questionnaires assessing socio-emotional comparisons, cognitive distortions, and depressive symptoms at each assessment period. Results indicated that both cognitive distortions and socio-emotional comparisons at baseline were correlated with three-month and six-month depressive symptoms. However, neither cognitive distortions, nor socio-emotional comparisons, were significant predictors of three-month and six-month depressive symptoms after accounting for age, gender, and baseline depressive symptoms. Finally, three-month socio-emotional comparisons partially mediated the association between baseline cognitive distortions and six-month depressive symptoms, even after controlling for baseline depressive symptoms. The results of this study suggest that cognitive distortions and negative socio-emotional comparisons are both a byproduct of depressive thinking; however, continually heightened cognitive distortions may fuel socio-emotional comparisons, which may in turn act as a partial predictor for future depression regardless of severity of initial depressive symptoms.
Open Access
Intimate Partner Violence in Rural and Northern Communities: A Canadian Perspective
(Faculty of Graduate Studies and Research, University of Regina, 2020-06) Wuerch, Melissa Anne; Wright, Kristi; Klest, Bridget; Juschka, Darlene; Williams, Jaime; Beshai, Shadi; Martin, Stephanie
Over the past decade, research has largely focused on the type, frequency, and severity of intimate partner violence (IPV) incidents, and has also documented the significant long-term consequences associated with experiencing IPV. To date, a large proportion of research examining IPV in relation to geographical location has focused on urban centres, which cannot be generalized to non-urban areas due to landscape differences (Burke, O’Campo, & Peak, 2006). Furthermore, a small proportion of research has begun to explore the complexities associated with living in rural and northern regions; however, the bulk of these studies span international contexts, and thus, cannot be generalized to a Canadian context (e.g., Beyer, Wallis, & Hamberger, 2015; Zakar, Zakar, & Abbas, 2016). Therefore, although important contributions have been made to increase our understanding of IPV in rural and northern communities, research examining this important topic within a Canadian context is limited (Moffitt, Fikowski, Mauricio, & Mackenzie, 2013; Wuerch, Zorn, Juschka, & Hampton, 2019; Zorn, Wuerch, Faller, & Hampton, 2017). This community-based research expanded on two previous studies, entitled “Canadian Domestic Homicide Prevention Initiative with Vulnerable Populations” and “Rural and Northern Community Response to Intimate Partner Violence,” which were funded by SSHRC and SSHRC/CURA, respectively. The purpose of the current investigation was to: (1) explore the challenges that service providers face when supporting survivors of IPV in rural and northern communities, (2) explore the barriers that survivors of IPV face when seeking refuge in rural and northern communities, and (3) identify helpful and/or promising practices being implemented within geographically diverse regions in Saskatchewan. Thus, semi-structured, qualitative interviews were completed with 16 services providers from rural regions and 16 service providers from northern regions within Saskatchewan, Canada. Data collection and analysis was guided by thematic analysis as recommended by Braun and Clarke (2016) through a phenomenological lens (Pietkiewicz & Smith, 2014). Six overarching themes were identified for rural communities, including Root Causes of IPV, Barriers to Leaving IPV Relationships and Accessing Services, Areas in Need of Improvement and Change, Working with Indigenous Peoples, Promising Practices in Rural Communities, and Overall Perception of Work as a Service Provider. In addition, six overarching themes were identified for northern communities, including A Cycle of Disadvantage, Barriers to Leaving IPV Relationships and Accessing Services, Areas in Need of Improvement and Change, Concern about Court Structure and Police Services, Promising Practices in Northern Communities, and Overall Perception of Work as a Service Provider. Higher order themes and subthemes were further identified for the overarching themes. The knowledge gained from the current research will be used to enhance, inform, and improve the effectiveness of national services and the allocation of funding to support survivors of IPV in rural and northern communities within Canada.
Open Access
Intolerance of Uncertainty Fuels Depressive Symptoms through Rumination: Cross-Sectional and Longitudinal Studies
(Public Library of Science, 2019-11-19) Huang, Vivian; Yu, Mabel; Carleton, R. Nicholas; Beshai, Shadi
The current study replicated and extended previous studies by examining the mediating and moderating role of rumination in the relationship between intolerance of uncertainty (IU) and depression in a community sample using both cross-sectional (n = 494; 56.9% female) and a two-months longitudinal (n = 321; 48.4% female) designs. Participants in each study were recruited through online crowdsourcing websites and completed study questionnaires. Results from Study 1 suggested that, while rumination did not appear to moderate the relationship between IU and depression, rumination appeared to partially mediates such relationship. Results from Study 2 supported rumination as fully mediating the relationship between IU and depression over two months. The brooding and reflection rumination subtypes exerted a significant indirect, but not moderating, effect on the relationship between IU and depression. Brooding exhibited a stronger mediation effect than did reflection. Overall, current results suggest that high levels of IU fuel the development of depression symptoms over time through engagement in heightened rumination. The IU-depression association appeared fully explained through rumination as it is a passive and contextually-dependent coping response that may enhance individuals’ emotion and facilitate the development of depressive symptoms.
Open Access
Investigating the Relationship Between Problematic Smartphone Use, Intolerance of Uncertainty, And Mindfulness
(Faculty of Graduate Studies and Research, University of Regina, 2021-09) Korol, Stephanie; Carleton, R. Nicholas; Asmundson, Gordon; Beshai, Shadi; Camp, Ronald; Mahoney, Alison
Problematic smartphone use (PSU) describes subjective distress, impairment, and/or negative consequences in important areas of functioning due to an inability to regulate smartphone usage (Billieux, 2012; Merlo et al., 2013). PSU is correlated with several mental health concerns, including symptoms of depression, anxiety, and perceived stress (Demirci et al., 2015; Elhai et al., 2017; Elhai et al., 2019; Samaha et al., 2016). Intolerance of uncertainty (IU) is related to numerous anxiety-related disorders (Carleton 2016a, 2016b) and may be a transdiagnostic cognitive mechanism relevant to PSU. A statistically significant increase in IU and smartphone usage from 1999 to 2014 suggests a relationship between IU and increasing smartphone use (Carleton et al., 2019). Smartphone use may increase access to reassurance, therein acting as a safety cue for those with heightened levels of IU (Carleton et al., 2019). Online mindfulness-based interventions (MBIs) may be an easily-accessible option for reducing IU and PSU, by increasing awareness and non-judgmental observations of the present moment (Bishop et al., 2004). Online MBIs produce reductions in anxiety-related symptoms (e.g., Cavanagh et al., 2013; Krusche et al., 2013; Querstret et al., 2018), but have not been explored as targeted interventions for IU and PSU. The current randomized control trial aimed to: 1) assess the effectiveness of an online MBI in reducing IU, PSU, and anxiety-related symptoms, and increasing mindfulness; 2) assess whether an accurate measure of smartphone use is associated with IU over time; and 3) assess whether PSU is associated with IU over time. Eligible participants were randomized to one of the following groups: 1) Waitlist Control condition, 2) Active Control condition (actively reducing smartphone use), or 3) MBI Treatment condition. Primary outcome measures of PSU, IU, and mindfulness, as well as secondary outcome measures of anxiety-related symptoms, were completed by participants once per week for five weeks while participants were asked to record their smartphone use via a smartphone monitoring application. Participants in the MBI Treatment condition participated in a weekly online MBI for four weeks. Participants in the Active Control condition were asked to decrease their smartphone use each week and watch a nature film equivalent to the length of the MBI videos each week. Multilevel linear modeling was used to test the effectiveness of the online MBI in reducing levels of IU, PSU, and anxiety-related symptoms, and increasing levels of mindfulness. Correlational analyses were used to assess the relationship between IU, smartphone use, and PSU over time. Participants in the MBI Treatment condition demonstrated superiority in decreasing symptoms of anxiety, relative to the Waitlist Control condition, but not the Active Control condition. Participants in the MBI Treatment condition also demonstrated superiority in increasing levels of mindfulness relative to both Control conditions, particularly at later time points. Across conditions, levels of IU and depression decreased over time, and initial levels of mindfulness increased, suggesting a possible effect of the smartphone monitoring application. Further, the MBI Treatment and Active Control conditions appear to be effective in reducing PSU. Lastly, PSU, but not general smartphone use, appears to be related to IU over time; therefore, how one uses their smartphone may be more relevant to IU than how much one uses their smartphone.
Open Access
Mental Disorder Symptoms among Public Safety Personnel in Canada
(SAGE Publications, 2017-08-28) Carleton, R. Nicholas; Afifi, Tracie O.; Turner, Sarah; Taillieu, Tamara L.; Duranceau, Sophie; LeBouthillier, Daniel, M.; Sareen, Jitender; Ricciardelli, Rosemary; MacPhee, Renée, S.; Groll, Dianne; Hozempa, Kadie; Brunet, Alain; Weekes, John R.; Griffiths, Curt T.; Abrams, Kelly J.; Jones, Nicholas A.; Beshai, Shadi; Cramm, Heidi; Dobson, Keith S.; Hatcher, Simon; Keane, Terence M.; Stewart, Sherry H.; Asmundson, Gordon J.G.
Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP.
Open Access
Personal relative deprivation associated with functional disorders via stress: An examination of fibromyalgia and gastrointestinal symptoms
(Public Library of Science, 2017-12-27) Beshai, Shadi; Mishra, Sanju; Mishra, Sandeep; Carleton, R. Nicholas
Personal relative deprivation is a negative social comparison process typified by self-com- parison, negative appraisal, and resultant negative emotionality. Personal relative depriva- tion has been associated with poorer physical and mental health in several domains. It has been hypothesized that the deprivation-health link operates through a stress pathway. Stress has been specifically implicated in the onset and maintenance of functional disor- ders, including fibromyalgia and functional gastrointestinal disorders. Despite the theoretical links between personal deprivation, stress, and functional disorders, researchers have not assessed relationships between these variables.
Open Access
Problem recognition and treatment recommendations of somatic and cognitive-affective presentations of depression and generalized anxiety
(Faculty of Graduate Studies and Research, University of Regina, 2023-08) Salimuddin, Saba; Beshai, Shadi; Klest, Bridget; Oriet, Chris; LeDrew, June
Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are among the leading causes of disability in the world; yet, rates of treatment seeking are exceptionally low. Poor mental health literacy is an important barrier to treatment seeking. One component of mental health literacy that impedes help seeking is poor problem recognition, or misidentifying a disorder and its symptoms when they are present. Although a wealth of research has established that accuracy of problem recognition is associated with help seeking related constructs (e.g., types of treatments recommended, intentions to seek treatment), no study to date has examined problem recognition of MDD or GAD across varying symptom presentations. The current study aimed to examine rates of problem recognition of MDD and GAD across predominantly somatic and cognitiveaffective presentations. To address the study aims, N = 299 participants were recruited using TurkPrime. N = 292 participants were randomly assigned to either the cognitive affective condition in which they were presented with case-study vignettes of MDD and GAD with predominantly cognitive-affective presentations, or the somatic condition in which they were presented with case-study vignettes of MDD and GAD with predominantly somatic presentations. Participants’ problem recognition and treatment recommendations were assessed following each vignette. We found significant main effects of disorder (i.e., MDD, GAD) and presentation (i.e., somatic, cognitive-affective) on problem recognition, such that MDD was associated with higher recognition than GAD, and cognitive-affective presentations were associated with higher recognition than somatic presentations. A large effect of disorder, and a small effect of presentation were observed. The interaction effect of disorder and presentation on problem recognition was non-significant. Further, problem recognition was associated with treatment recommendations. However, disorder and presentation were not related to treatment recommendations. We also found a significant difference in treatment recommendations made for self and others. Findings from the current study fill a gap in the literature by providing an initial understanding of mental health literacy across symptom presentations. This is likely to aid in the further development of mental health literacy programs. Clinically, these findings also have the potential to help avoid misdiagnoses and the diagnostic delays associated with somatic presentations of MDD and GAD.