Suzanne Cosh | University of New England - Australia (original) (raw)

Papers by Suzanne Cosh

Objective: The study explored relationships between preferences for and experiences of clinical d... more Objective: The study explored relationships between preferences for and experiences of clinical decision making (CDM) with service use among persons with severe mental illness. Methods: Data from a prospective observational study in six European countries were examined. Associations of baseline staff-rated (N=213) and patient-rated (N=588) preferred and experienced decision making with service use were examined at baseline by using binomial regressions and at 12-month follow-up by using multilevel models. Results: A preference by patients and staff for active patient involvement in decision making, rather than shared or passive decision making, was associated with longer hospital admissions and higher costs at baseline and with increases in admissions over 12 months (p=.043). Low patient-rated satisfaction with an experienced clinical decision was also related to increased costs over the study period (p=.005). Conclusions: A preference for shared decision making may reduce health care costs by reducing inpatient admissions. Patient satisfaction with decisions was a predictor of costs, and clinicians should maximize patient satisfaction with CDM.

Background. Substantial healthcare resources are devoted to panic disorder (PD) and coronary hear... more Background. Substantial healthcare resources are devoted to panic disorder (PD) and coronary heart disease (CHD); however, the association between these conditions remains controversial. Our objective was to conduct a systematic review of studies assessing the association between PD, related syndromes, and incident CHD.

The Sport Psychologist, 2015

Participation in elite-sport and education is stressful and can result in sacrificed educational ... more Participation in elite-sport and education is stressful and can result in sacrificed educational attainment. A dearth of research, however, has explored the specific stressors encountered by student athletes and coping strategies used, resulting in limited knowledge of how to best support student athletes. Interviews with 20 Australian university student athletes were conducted and data were analyzed via thematic analysis. Interviewees reported encountering numerous stressors, especially relating to schedule clashes, fatigue, financial pressure, and inflexibility of coaches. Athletes identified few coping strategies but reported that support from parents and coaches was paramount. Athletes would benefit from upskilling in several areas such as effective use of time, self-care, time management, enhanced self-efficacy, and specific strategies for coping with stress. Coaches have the opportunity to play a pivotal role in facilitating successful integration of sport and education.

Systematic reviews, 2015

The clinical presentation of panic disorder and panic attack overlaps many symptoms typically exp... more The clinical presentation of panic disorder and panic attack overlaps many symptoms typically experienced in coronary heart disease (CHD). Etiological links between panic disorder and CHD are controversial and remain largely tenuous. This systematic review aims to pool together data regarding panic disorder with respect to incident CHD or myocardial infarction. Electronic databases (MEDLINE, EMBASE, PsycINFO and SCOPUS) will be searched using a search strategy exploding the topics for CHD and panic disorder. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: persons without CHD who meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms; Comparison: persons without CHD who do not meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms; verified fatal and non-fatal CHD at follow-up;...

Qualitative Research in Sport, Exercise and Health, 2014

Prevalence of disordered eating is higher in athlete populations than in the general population. ... more Prevalence of disordered eating is higher in athlete populations than in the general population. This paper explores the sociocultural context within which athletes are vulnerable to poor health behaviours and potentially poor mental health. Within sport settings, dominant ideals of body regulation and self-surveillance are normalised and leave athletes vulnerable to eating disorders. This paper explores how such ideals and understandings around the body are reproduced within the sporting environment during everyday interactions and how body regulatory practices come to be normalised. This paper draws on discursive psychology, informed by conversation analysis, to examine the news delivery sequences of 40 interactions occurring between elite athletes and sport staff during routine practices of body composition testing taking place in an Australian sport institute network. Through the news delivery sequences of body composition testing scores, practices of body regulation come to be normalised by both athletes and sport staff. Moreover, athletes are positioned as needing continually to improve, thus, (re)producing dominant notions of body regulation as requiring athletes' self-discipline and surveillance. Discursive practices occurring in sport settings can leave athletes at increased risk of developing unhealthy eating and exercising behaviours and disordered eating. Implications for practice for sport staff are discussed.

Psychology of Sport and Exercise, 2015

Background: The transition out of elite sport can be distressing and many athletes experience a r... more Background: The transition out of elite sport can be distressing and many athletes experience a range of transition difficulties. However, the socio-cultural and discursive contexts which shape experiences remain largely unexplored in the transition literature. Objective: To explore retirement and transition difficulties in a cultural context through an analysis of Australian newsprint media. Design and methods: A discursive analysis of 121 media articles reporting on post-retirement experiences of two Australian swimmers 7 and 5 years (respectively) into retirement. Data were analysed for repeated representation of transition difficulties, specifically how the cause of difficulties was attributed. The identities that were ascribed to athletes and what these functioned to accomplish were also examined. Results: The identities of both individuals were repeatedly constructed in terms of an athlete identity, to the exclusion of other identities. The responsibility for transition difficulties was depicted as located solely within the individual and, thereby, the sport setting and the broader socio-cultural context were overlooked. Conclusions: In this cultural context (Australian news media), the repeated construction of limited identity positions for retired athletes and the construction of former athletes as the sole locus of transition difficulties have implications for their psychological well-being. Despite this, the role of the sporting and cultural context is rendered invisible in these accounts and more broadly, and interventions remain targeted at the individual level.

Journal of psychosomatic research, 2014

To (1) report the prognostic association between anxiety disorder subtypes and major adverse card... more To (1) report the prognostic association between anxiety disorder subtypes and major adverse cardiac events (MACE), (2) report anxiety disorder prevalence in coronary heart disease (CHD), and (3) report the efficacy of anxiety disorder treatments in CHD. A comprehensive electronic database search was performed in November 2013 for studies reporting anxiety disorder prevalence according to structured interview in CHD samples or MACE, and randomized controlled trials (RCTs) comparing anxiety disorder treatment with placebo or usual care. From 4041 articles 42 samples were selected for extraction (8 for MACE prognosis, 39 for prevalence, no RCTs were eligible). Five generalized anxiety disorder (GAD) studies reported 883 MACE events (combined n=2851). There was a non-significant association between GAD and MACE (risk ratio=1.20, 95% CI .86-1.68, P=.28) however the effect size was highly significant in outpatient samples (adjusted hazard ratio=1.94, 95% CI 1.45-2.60, P<.001). No othe...

Australian Journal of Primary Health, 2014

Smoking prevalence among Aboriginal Australian young people greatly exceeds the prevalence in the... more Smoking prevalence among Aboriginal Australian young people greatly exceeds the prevalence in the broader population of Australian young people, yet limited research has explored the social context in which young Aboriginal Australians smoke. Four focus groups were conducted in 2009 with South Australian Aboriginal smokers aged 15-29 years residing in urban areas (n = 32) to examine attitudes and experiences surrounding smoking and quitting. The primary reasons for smoking initiation and maintenance among Aboriginal Australian young people were identified as stress, social influence and boredom. Motivators for quitting were identified as pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons. The barriers to cessation were identified as social influence, the perception of quitting as a distant event and reluctance to access cessation support. However, it appears that social influences and stress were particularly salient contributors to smoking maintenance among Aboriginal Australian young people. Smoking cessation interventions targeted at young urban Aboriginal Australian smokers should aim to build motivation to quit by utilising the motivators of pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons, while acknowledging the pertinent role of social influence and stress in the lives of young urban Aboriginal Australian smokers.

Psychology, Health & Medicine, 2013

The aims of this review article are to present psychophysiological and behavioral pathways for th... more The aims of this review article are to present psychophysiological and behavioral pathways for the involvement of worry and generalized anxiety disorder (GAD) upon cardiovascular function. The review will focus on persons with and without coronary heart disease (CHD), and encompass etiological and prognostic studies. Articles (1975-2011) reporting on GAD or worry affecting CHD prognosis or cardiovascular function were found using MEDLINE, EMBASE, SCOPUS and PsychINFO database searches, and extracted to form a narrative review. Available evidence in experimental and observational studies in CHD free samples consistently showed that worry was associated with diminished heart rate variability (HRV) and elevated heart rate. Worry and GAD were commonly associated with blood pressure and diagnosed hypertension or medication use in both disease-free and established CHD populations. No evidence was found to support worry being beneficial to cardiovascular function or conducive to health promoting behaviors. The literature indicated that measures of worry were associated with fatal and nonfatal CHD in seven etiological studies of initially disease-free individuals; however, females were underrepresented. Three studies reported that GAD was associated with poorer prognosis in establish CHD, independent of depression. The median GAD prevalence was 10.4% in 3266 patients across 15 studies, suggesting that GAD is marginally less common in CHD samples than is depression. A growing literature highlights the association between worry and development of CHD. The association between worry, GAD and CHD risk factors (e.g. blood pressure), and HRV are leading mechanisms of cardiopathogenesis that may affect cardiovascular function. Findings regarding worry and GAD in established CHD are less clear.

Journal of Language and Social Psychology, 2013

While there are generally strong cultural norms against discrimination based on individual charac... more While there are generally strong cultural norms against discrimination based on individual characteristics, there is a dearth of research on exactly how people understand a particular act to be an instance of (non)discrimination. This research examines 285 online posts discussing differential pricing of health insurance by gender to see how this is constructed, and disputed, as an instance of discrimination. Arguments legitimating differential pricing are based on statistical rhetoric and the invocation of a norm of differential pricing across insurance contexts. These arguments are contested by undermining the constructions of "risk" that statistics are based on, and disputing equivalence of insurance contexts. These findings suggest that straightforward claims about what is and what is not discrimination are difficult to make in practice. Highlighting the various ways that gender differentiated treatment can be legitimated and contested provides insight into the ways in which inequality is maintained and resisted within everyday situations.

Journal of Health Psychology, 2013

Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease... more Generalized anxiety disorder prevalence and comorbidity with depression in coronary heart disease patients remain unquantified. Systematic searching of Medline, Embase, SCOPUS and PsycINFO databases revealed 1025 unique citations. Aggregate generalized anxiety disorder prevalence (12 studies, N = 3485) was 10.94 per cent (95% confidence interval: 7.8-13.99) and 13.52 per cent (95% confidence interval: 8.39-18.66) employing Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria (random effects). Lifetime generalized anxiety disorder prevalence was 25.80 per cent (95% confidence interval: 20.84-30.77). In seven studies, modest correlation was evident between generalized anxiety disorder and depression, Fisher's Z = .30 (95% confidence interval: .19-.42), suggesting that each psychiatric disorder is best conceptualized as contributing unique variance to coronary heart disease prognosis.