Journal Articles
Published Research
The following is a summary of journal publications by Associate Professor Knowles. Click on the references below for further details.
Journal Articles
2023
Hlavac, J., Tobias, S., Sundin, L., Knowles, S., & Archila, A.A. (2023). The formalisation of professional development amongst translators and interpreters: Practices in five predominantly Anglophone countries with a focus on Australia. T&I Review, 13(1), 107-136.
Abstract:
Professional development has become standard practice for many occupational groups. While for some it may be a matter of individual choice, there are often a number of factors and entities that have a stake in the provision of or need for professional development, e.g. professional associations, industry regulatory bodies, training providers, consumer groups, employer representative groups and even governmental authorities. This paper employs the term ‘player’ as a generic term to encompass these different interest groups. This paper then examines the place that professional development has amongst organisations that certify, credential or register interpreters and/or translators to practise professionally. Based on a sample of 12 organisations, we find that five of them have professional development as a requirement for continuing practice, for four organisations it is voluntary and for three there is insufficient information. Comparison shows that the player role of professional association is supportive of professional development, but the most decisive factors were non-involvement as a provider and specific country. Further, we focus on Australia where the major player recently introduced mandatory professional development. Here, we report high rates of uptake not only amongst those who are certified, but also amongst those who are not. (Monash University, Australia; Swinburne University, Australia)
Romano, D., Chesterman, S., Fuller-Tyszkiewicz, M., Evans, S., Dober, M., Gearry, R., Gibson, P. R., Knowles, S., McCombie, A., O, E., Olive, L., Raven, L., Van Niekerk, L., & Mikocka-Walus, A. (2023). Feasibility, Acceptability, and Preliminary Efficacy of Acceptance Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress. Inflammatory bowel diseases, izad122. Advance online publication.
Abstract:
Background: The bidirectional relationship between IBD flare-ups and mental health has prompted investigations into psychotherapy to improve disease-related QoL by targeting distress. Acceptance commitment therapy (ACT) has been found to be effective in improving distress in people with chronic diseases, yet minimal research has examined ACT’s effectiveness in those with IBD. This study examines the feasibility, acceptability, and preliminary efficacy of the ACTforIBD program; an online, program designed to deliver ACT to those with IBD.
Methods: Sixty-two adults with IBD (89% women, 11% men, Mage=33) and mild-moderate distress, were randomized to either ACTforIBD or an active control (psychoeducation) condition. Participants completed eight, weekly, one-hour sessions, five of which were psychologist-facilitated, and four being self-directed. Feasibility was derived based on recruitment and retention, and acceptability was derived from satisfaction measures obtained post-program. Preliminary efficacy was determined by measures of distress and disease activity assessed at baseline, and post-program.
Results: Fifty-five participants completed the 8-week program (ACTforIBD: n=26 [83.9%], active control: n=29 [93.5%]). Adherence and acceptability were high, with 80% of participants completing all self-directed modules and 78% of participants expressing satisfaction with the program. Significant group*time interactions were found for anxiety symptoms (b=-1.94, 95%CI: -3.54; -.43) and anxiety/depression QoL (b=-.05, 95%CI: -.09; -.01), with the intervention group showing decreases in anxiety, and anxiety/depression QoL.
Conclusions: ACTforIBD is feasible, acceptable, and shows preliminary efficacy in targeting anxiety symptoms, and improving quality of life related to anxiety/depression. This highlights the need for a full-scale RCT to further examine the program’s efficacy.
Knowles, S.R., Apputhurai, P., Palsson, O.S., Bangdiwala, S., Sperber, A.D., & Mikocka-Walus, A. . The epidemiology and psychological comorbidity of disorders of gut-brain interaction in Australia: Results from the Rome Foundation Global Epidemiology Study. Neurogastroenterology and Motility, 35(6), e14594.
Abstract:
Background: The Rome Foundation Global Epidemiology Study on the disorders of gut-brain interaction (DGBI) was used to assess the national prevalence of all 22 DGBI, the percentage of respondents meeting diagnostic criteria for at least one DGBI, and the rates of comorbid anxiety, depression, and somatization in Australia and 25 other countries.
Methods: The survey was conducted in Australia and 25 other countries through the Internet and included the Rome IV Diagnostic Questionnaire and an in-depth supplemental questionnaire.
Key results: Two thousand thirty-six Australian adults completed the survey nationwide: mean age 47.34 ± 17.00 years, 50.15% males. Overall, 38.67% of Australians met criteria for at least one DGBI, with unspecified functional bowel disorder (8.01%) and then functional constipation (7.71%) being the most prevalent. For those Australians with at least one DGBI, rates of anxiety, depression, and somatization where high (26.58%, 28.96%, and 63.10%, respectively), with functional chest pain having the highest rates of anxiety (55.00%) and depression (57.50%), and irritable bowel syndrome (mixed) having the highest somatization rate (75.86%). The odds of having a DGBI increased with greater anxiety (OR: 1.09, CI 95%: 0.97, 1.23), depression (OR: 1.17, CI 95%: 1.04, 1.32), and somatization (OR: 1.17, CI 95%: 1.14, 1.20) symptom severity.
Conclusions and inferences: The current study represents the most comprehensive epidemiological exploration of DGBI and mental health in Australia to date, including their prevalence and distributions across sex and age, associations between DGBI and anxiety, depression, and somatization. The findings warrants future comparisons between population characteristics and health care systems differences in order to reduce the burden of DGBI and mental illness worldwide.
Naude, C., Skvarc, D., Knowles, S., Russell, L., Evans, S., & Mikocka-Walus, A. (2023). The effectiveness of mindfulness-based interventions in inflammatory bowel disease: A systematic review & meta-analysis. Journal of Psychosomatic Research, 169, 111232.
Abstract:
Background: Mental health has been identified as contributing to the pathogenesis of Inflammatory Bowel Disease (IBD). Resultingly, psychotherapeutic interventions, such as Mindfulness-Based Interventions (MBI), have been increasingly investigated for improving IBD outcomes.
Objectives: To systematically review the current state of evidence of MBI’s for individuals living with IBD.
Methods: We performed a systematic review searching Medline, PsychINFO, CINAHL, Embase, Cochrane and Scopus, to identify controlled clinical trials, investigating MBI’s for various IBD biopsychosocial outcomes. Data was pooled using the inverse-variance random effects model, with restricted maximum likelihood estimation, providing the standardized mean difference (SMD) between control and experimental groups, at both short and long-term follow up.
Results: We identified 8 studies with 575 participants. Meta-analytic results found that MBI’s were more efficacious than control groups in the short-term improvement of stress (SMD = −0.38, 95% CI [−0.65, −0.10], p = 0.007), mindfulness (SMD = 0.59, 95% CI [0.36, 0.83], p = 0.00001), C-Reactive Protein (CRP) (SMD = −0.25, 95% CI [−0.49, −0.01], p = 0.04) and health-related quality of life (HRQoL) (SMD = 0.45, 95% CI [0.24, 0.66], p = 0.0001) (including all emotional, bowel, social and systemic subscales). This was maintained in the long-term for stress (SMD = −0.44, 95% CI [−0.88, −0.01], p < 0.05) and mindfulness (SMD = 0.52, 95% CI [0.14, 0.90], p = 0.008), but not for HRQoL, with no long-term data available for CRP.
Conclusions: Given that MBI’s appear to be effective in improving several IBD outcomes, they may be a useful adjuvant therapy in wholistic IBD care, with further trials warranted.
URL: https://doi.org/10.1016/j.jpsychores.2023.111232
Knowles, S. R., Apputhurai, P., Jenkins, Z., O'flaherty, E., Ierino, F., Langham, R., Ski, C. F., Thompson, D. R., & Castle, D. J. (2023).). Impact of chronic kidney disease on illness perceptions, coping, self-efficacy, psychological distress and quality of life. Psychology, Health & Medicine, 1-14. Advance online publication.
Abstract:
Chronic kidney disease (CKD) negatively impacts psychological well-being and quality of life (QoL). Underpinned by the Common Sense Model (CSM), this study evaluated the potential mediating role of self-efficacy, coping styles and psychological distress on the relationship between illness perceptions and QoL in patients living with CKD. Participants were 147 people with stage 3-5 kidney disease. Measures included eGFR, illness perceptions, coping styles, psychological distress, self-efficacy and QoL. Correlational analyses were performed, followed by regression modelling. Poorer QoL was associated with greater distress, engagement in maladaptive coping, poorer illness perceptions and lower self-efficacy. Regression analysis revealed that illness perceptions predicted QoL, with psychological distress acting as a mediator. The proportion of variance explained was 63.8%. These findings suggest that psychological interventions are likely to enhance QoL in CKD, if they target the mediating psychological processes associated with illness perceptions and psychological distress.
URL: https://doi.org/10.1080/13548506.2023.2179644
Knowles, S. R., Möller, S. P., Stengel, A., Mikocka-Walus, A., Ferreira, N., Trindade, I. A., Mokrowiecka, A., Burisch, J., Barreiro-de Acosta, M., Bernstein, C. N., Lo, B., & Skvarc, D. (2023). Exploring the impact of Covid-19-related perceptions on psychological distress and quality of life in an international gastrointestinal cohort over time guided by the common sense model. Journal of Clinical Psychology in Medical Settings, 1-17. Advance online publication.
Abstract:
The aim of this longitudinal study was to examine changes in COVID-19 and illness-related perceptions, gastrointestinal symptoms, coping, catastrophising, psychological distress, and QoL during the COVID-19 pandemic. A total of 831 adults with a gastrointestinal condition completed an online questionnaire at baseline (May-October 2020). Of those, 270 (32.5%) participants (85.2% female, mean age = 47.3 years) provided follow-up data (March-May 2021). Repeated-measures multiple analysis of variance and a cross-lagged panel model were used to test the study hypotheses. Gastrointestinal symptoms and COVID-19 perceptions at follow-up were strongly predicted by their baseline values, while illness perceptions were predicted by baseline gastrointestinal symptoms. Cross-lagged relationships indicated a reciprocal relationship between gastrointestinal symptoms and psychological distress. Moreover, gastrointestinal symptoms had substantial predictive utility, strongly predicting future gastrointestinal symptoms, and to a lesser extent, more negative illness perceptions, greater psychological distress, and greater use of adaptive coping strategies across time.
URL: https://doi.org/10.1007/s10880-023-09937-5
Knowles, S. R., Skvarc, D., Ford, A. C., Palsson, O. S., Bangdiwala, S. I., Sperber, A. D., & Mikocka-Walus, A. (2023). Negative impact of disorders of gut-brain interaction on health-related quality of life: Results from the Rome Foundation Global Epidemiology Survey. Gastroenterology, 164(4), 655-668.e10
Abstract:
Background & Aims: This study used the database from the Rome Foundation Global Epidemiology Survey to assess the differences in quality of life overall, and by age and sex, across individual disorders of gut-brain interaction (DGBI), gastrointestinal anatomical region(s), and number of overlapping DGBI.
Methods: Data were collected via the Internet in 26 countries, using the Rome IV diagnostic questionnaire and a supplemental questionnaire including the Patient-Reported Outcomes Measurement Information Systems Global-10 quality of life measure. Factorial analyses of variance were used to explore physical and mental quality of life, adjusting for multiple comparisons.
Results: Among the 54,127 respondents, quality of life deteriorated significantly with increasing number of overlapping DGBI, with respondents reporting ≥2 DGBI having significantly poorer quality of life than those with only 1 DGBI or those without any DGBI. Men with DGBI reported better quality of life than women, and those aged ≥65 years reported better quality of life than those <65 years. Age, sex, number of overlapping DGBI, somatization, anxiety, depression, and functional experiences (concern, embarrassment, or stress associated with bowel functioning) relating to DGBI, were significant predictors of poorer physical and mental quality of life.
Conclusions: This study is the most comprehensive assessment of quality of life to date in adults living with a DGBI. It provides a representative picture of DGBI impact on adults in the global adult population and highlights the significant detrimental impact of living with a DGBI on quality of life.
URL: https://doi.org/10.1053/j.gastro.2022.12.009
Knowles, S. R. (2023) Space invaders: Socio-cognitive processes are associated with paruresis symptoms and public urinal avoidance in male university students. Psychological Studies, 68, 82-9.
Abstract:
Paruresis, also known as shy bladder, refers to the condition where the perception of perceived scrutiny of others leads to a difficultly (or inability) in urinating in restrooms. The aim of the study was to identify the prevalence of public urinal avoidance and the potential efficacy of an extended bivalent fear of evaluation model of paruresis to predict public urinal avoidance. 191 male university students (mean age = 28.66 years) completed an online questionnaire which included ten public urinal vignettes. The results indicated that an average of 35.08% of participants avoided an available urinal due to anxiety associated with being around others, while a further 42% avoided urinals due to fears relating to contamination. Based on structural equation modelling, the extended bivalent fear of evaluation model of paruresis was found to predict public urinal avoidance (χ2 p-value = .123, Normed Chi-square = 1.446, Comparative Fit Index = .986, Tucker–Lewis index = .973, Steiger-Lind Root Mean Square Error of Approximation = .049, Standardised Root Mean Squared Residual = .048). Paruresis symptoms were found to be influenced by several socio-cognitive processes, including dysfunctional attitudes, fear of positive and negative evaluation and concerns of social reprisal. Extending past research was the finding that the extended bivalent fear of evaluation model of paruresis predicted urinal avoidance. Overall, the results provide evidence that public urinal avoidance is common and is likely to be underpinned by socio-cognitive processes and paruresis symptoms.
Mikocka-Walus, A., Evand, S., Linardon, J., Wilding, H., & Knowles, S.R. (2023) Psychotherapy appears to improve symptoms of functional dyspepsia and anxiety: Systematic review with meta-analysis. Psychology, Health & Medicine, 28(5), 1309-1335.
Abstract:
This systematic review and meta-analysis examined the efficacy of psychotherapy on symptoms of functional dyspepsia, anxiety, depression and quality of life. We searched Medline, Embase, PsycINFO, Emcare, Ovid Nursing, CINAHL, Cochrane Library, Informit Health Collection and ClinicalTrials.gov on 2 July 2021. Randomised controlled trials that compared psychotherapy to non-psychotherapy interventions in adults with functional dyspepsia were included. Meta-analyses were conducted (using Hedges’s g) under random effects models. Overall, 1,575 records were identified after duplicates were removed, with nine randomised controlled trials (n = 786) included. Preliminary meta-analyses showed that psychotherapy outperformed control conditions at post-test and follow-up on functional dyspepsia symptom severity and anxiety symptoms, but no differences emerged for depressive symptoms. The qualitative synthesis showed psychotherapy’s promise in improving quality of life in functional dyspepsia. Psychotherapy might have a small to moderate effect on functional dyspepsia symptoms and anxiety at short- and long-term. However, conclusions are limited by the small number of trials with a high risk of bias.
URL: https://doi.org/10.1080/13548506.2022.2141278