David has worked as a clinical psychologist in a variety of community-based and inpatient mental health settings since 2001, and he has particular experience in the treatment of anxiety disorders. He has conducted numerous research projects in clinical settings and was a Senior Research Fellow in trauma and mental health in the School of Psychiatry UNSW and St John of God Health Care - Richmond hospital before commencing his current role.
His research aims to optimise treatment outcomes for people with posttraumatic and anxiety disorders by focusing on the translation of research findings to routine clinical practice.
David is an endorsed clinical psychologist and supervisor with the Psychology Board of Australia and also supervises postgraduate research projects.
He is currently a National Health and Medical Research Council (NHMRC) Early Career Fellow and chief investigator on two Australian Research Council (ARC) funded projects pertaining to: 1. the temporal focus of trauma-related symptoms in refugees and asylum seekers (Discovery Project, CIB) and 2. the adjustment of asylum seekers and refugees during the post- resettlement period (Linkage project, CID). He is an associate editor of the International Journal of Mental Health and Addiction and BMC Psychiatry and he is a member of numerous professional organisations including the Australian Clinical Psychology Association and the International Society for Traumatic Stress Studies.
Conjoint Senior Lecturer, School of Psychiatry UNSW.
Can supervise: YES
- Cognitive and emotional processes in Posttraumatic Stress Disorder (PTSD), obsessive-compulsive-disorder (OCD), and anxiety disorders.
- Experience-sampling and ecological momentary assessment-based approaches.
- Relapse and recurrence of symptoms in PTSD and high-prevalence disorders.
McMullan, R, Berle, D, Arnáez, S & Starcevic, V 2019, 'The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis', Journal of Affective Disorders, vol. 245, pp. 270-278.View/Download from: UTS OPUS or Publisher's site
Cyberchondria refers to an abnormal behavioral pattern in which excessive or repeated online searches for health-related information are distressing or anxiety-provoking. Health anxiety has been found to be associated with both online health information seeking and cyberchondria. The aims of the present systematic review and meta-analysis were to examine the magnitude of these associations and identify any moderator variables.
A systematic literature search was performed across several databases (PsycINFO, PubMed, Embase) and reference lists of included studies.
Twenty studies were included across two independent meta-analyses, with 7373 participants. Random effects meta-analyses showed that there was a positive correlation between health anxiety and online health information seeking [r = 0.34, 95% CI (0.20, 0.48), p < .0001], and between health anxiety and cyberchondria [r = 0.62, 95% CI (0.52, 0.71), p < .0001]. A meta-regression indicated that the age of study participants [Q(1) = 4.58, p = .03] was partly responsible for the heterogeneity found for the relationship between health anxiety and cyberchondria.
Berle, D, Starcevic, V, Khazaal, Y, Viswasam, K, Hede, V & McMullan, RD 2019, 'Relationships between online health information seeking and psychopathology.', General hospital psychiatry.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Baggio, S, Berle, D, Khazaal, Y & Viswasam, K 2019, 'Cyberchondria and its relationships with related constructs: a network analysis', Psychiatric Quarterly.View/Download from: Publisher's site
Berle, D, Starcevic, V, Viswasam, K, Milicevic, D, Hannan, A, Brakoulias, V & Zachary, S 2018, 'Confirmatory factor analysis of the Nepean Dysphoria Scale in a clinical sample.', Psychiatric Quarterly, vol. 89, no. 3, pp. 621-629.View/Download from: UTS OPUS or Publisher's site
The construct of dysphoria has been described inconsistently across a broad range of psychopathology. The term has been used to refer to an irritable state of discontent, but is also thought to incorporate anger, resentment and nonspecific symptoms associated with anxiety and depression, such as tension and unhappiness. The Nepean Dysphoria Scale has been developed to allow assessment of dysphoria, but its factor structure has not yet been investigated in clinical samples. We aimed to determine the latent structure of dysphoria as reflected by the Nepean Dysphoria Scale, using a clinical sample. Adults (N = 206) seeking treatment at a range of mental health services were administered the Nepean Dysphoria Scale. Four putative factor structures were investigated using confirmatory factor analysis: a single-factor model, a hierarchical model, a bifactor model and a four-factor model as identified in previous studies. No model fit the data except for a four-factor model when a revised 22-item version of the original 24-item scale was investigated. A four-factor structure similar to that identified in non-clinical samples was supported, albeit following the removal of two items. The Nepean Dysphoria Scale appears to have utility for the assessment of dysphoria in routine clinical settings.
Berle, D, Hilbrink, D, Russell-Williams, C, Kiely, R, Hardaker, L, Garwood, N, Gilchrist, A & Steel, Z 2018, 'Personal wellbeing in posttraumatic stress disorder (PTSD): association with PTSD symptoms during and following treatment.', BMC Psychology, vol. 6, no. 7, pp. 1-6.View/Download from: UTS OPUS or Publisher's site
It remains unclear to what extent treatment-related gains in posttraumatic stress disorder (PTSD) symptoms translate to improvements in broader domains of personal wellbeing, such as community connectedness, life achievement and security. We sought to determine whether: 1. personal wellbeing improves during the course of a treatment program and 2. changes in core symptom domains (PTSD, anxiety and depression) were associated with improvements in overall personal wellbeing.
Participants (N = 124) completed the PTSD Checklist, the Depression and Anxiety Stress Scales and the Personal Wellbeing Index at the start and end of a 4-week Trauma Focused CBT residential program, as well as 3- and 9-months post-treatment.
Personal wellbeing improved significantly across the 9-months of the study. Generalised estimating equations analyses indicated that (older) age and improvements in PTSD and depressive symptoms were independent predictors of personal wellbeing across time.
Although personal wellbeing improved in tandem with PTSD symptoms, the magnitude of improvement was small. These findings highlight a need to better understand how improvements in personal wellbeing can be optimised following PTSD treatment.
Hannan, A, Berle, D, Milicevic, D, Dale, E, Starcevic, V, Brakoulias, V & Viswasam, K 2018, 'Routine treatment duration for clients attending a community based anxiety disorders clinic', Australasian Psychiatry, vol. 26, no. 3, pp. 307-310.View/Download from: UTS OPUS or Publisher's site
© 2016, The Royal Australian and New Zealand College of Psychiatrists 2016. Objective: To determine the average duration of treatment at a community-based anxiety disorders clinic. Method: Data were collected on primary disorder, the presence of co-occurring disorders and treatment length (both in terms of number of sessions and weeks of therapy) for 248 consecutive clients. Results: The mean number of sessions was 13, and average treatment length was 29 weeks. There was substantial variation in treatment duration (range for number of sessions = 1–128, range for treatment duration = 0–186 weeks). Conclusion: Clients with anxiety disorders were often treated in relatively few sessions, in line with randomised controlled trials (RCTs). However, a number of clients required many more sessions and were treated for a longer period of time than clients in RCTs. Health services should be cautious in mandating limits to therapy duration for anxiety disorders given the wide range in the duration of treatment for clients in our sample.
Padoa, T, Berle, D & Roberts, L 2018, 'Comparative Social Media Use and the Mental Health of Mothers With High Levels of Perfectionism.', Journal of Social and Clinical Psychology, vol. 37, no. 7, pp. 514-535.View/Download from: UTS OPUS or Publisher's site
Social media is thought to communicate idealized images and discourses of motherhood. As such, it may present as a risk factor for poor mental health in mothers who strive for perfection and compare themselves to the ideals presented on social media. The present study examined the influence of Facebook and In-stagram on the relationship between perfectionism in mothers and their mental health. A sample of 201 mothers completed an online survey. Two dimensions of perfectionism were assessed: Self-Orientated Parenting Perfectionism (SOPP) and Societal-Prescribed Parenting Perfectionism (SPPP). Mediation models were conducted to examine social media frequency and social comparison respectively on the relationship between perfectionism and maternal mental health. Results revealed that for mothers with SOPP, the process of social comparison with other mothers on social media contributed to symptoms of anxiety and depression. The amount of time engaging in social media however, had no impact. In contrast, for mothers with SPPP, the amount of time spent on Facebook contributed to symptoms of depression and anxiety, while the process of social comparison led to anxiety symptoms alone. Social comparison appears to be important for perfectionistic mothers who use social media, as this may contribute to negative mental health outcomes.
Berle, D, Steel, Z, Essue, BM, Keay, L, Jan, S, Tan Phuc, H & Hackett, ML 2017, 'Multisite prospective investigation of psychological outcomes following cataract surgery in Vietnam.', BMJ Global Health, vol. 2, pp. e000162-e000162.View/Download from: UTS OPUS or Publisher's site
Berle, D 2017, ''Just think positive': We can all work to address the publication bias issue.', Australian and New Zealand Journal of Psychiatry, vol. 51, no. 5, pp. 536-536.View/Download from: UTS OPUS or Publisher's site
Berle, D, Starcevic, V, Milicevic, D, Hannan, A, Dale, E, Skepper, B, Viswasam, K & Brakoulias, V 2016, 'The structure and intensity of self-reported autonomic arousal symptoms across anxiety disorders and obsessive-compulsive disorder', JOURNAL OF AFFECTIVE DISORDERS, vol. 199, pp. 81-86.View/Download from: UTS OPUS or Publisher's site
Brakoulias, V, Starcevic, V, Martin, A, Berle, D, Milicevic, D & Viswasam, K 2016, 'The familiality of specific symptoms of obsessive-compulsive disorder', PSYCHIATRY RESEARCH, vol. 239, pp. 315-319.View/Download from: Publisher's site
Berle, D, Moulds, ML, Starcevic, V, Milicevic, D, Hannan, A, Dale, E, Viswasam, K & Brakoulias, V 2016, 'Does emotional reasoning change during cognitive behavioural therapy for anxiety?', COGNITIVE BEHAVIOUR THERAPY, vol. 45, no. 2, pp. 123-135.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Berle, D, do Rosario, MC, Brakoulias, V, Ferrao, YA, Viswasam, K, Shavitt, R, Miguel, E & Fontenelle, LF 2016, 'Use of benzodiazepines in obsessive-compulsive disorder', INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY, vol. 31, no. 1, pp. 27-33.View/Download from: UTS OPUS or Publisher's site
Berle, D & Steel, Z 2015, 'Families of returned defence force personnel: a changing landscape of challenges', AUSTRALASIAN PSYCHIATRY, vol. 23, no. 4, pp. 399-402.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Berle, D, Viswasam, K, Hannan, A, Milicevic, D, Brakoulias, V & Dale, E 2015, 'Specificity of the Relationships Between Dysphoria and Related Constructs in an Outpatient Sample', PSYCHIATRIC QUARTERLY, vol. 86, no. 4, pp. 459-469.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Brakoulias, V, Viswasam, K & Berle, D 2015, 'Inconsistent Portrayal of Medication Dependence, Withdrawal and Discontinuation Symptoms in Treatment Guidelines for Anxiety Disorders', PSYCHOTHERAPY AND PSYCHOSOMATICS, vol. 84, no. 6, pp. 379-380.View/Download from: Publisher's site
Berle, D, Starcevic, V, Porter, G & Fenech, P 2015, 'Are some video games associated with more life interference and psychopathology than others? Comparing massively multiplayer online role-playing games with other forms of video game', Australian Journal of Psychology, vol. 67, no. 2, pp. 105-114.View/Download from: UTS OPUS or Publisher's site
© 2014 The Australian Psychological Society. Massively multiplayer online role-playing games (MMORPGs) are a type of video game that is considered to have particular potential to be associated with life interference and psychopathology when played frequently and intensively. This study sought to compare players of MMORPGs with players of other types of video game in terms of problematic use, life interference, and levels of psychopathology. An international sample of 1,945 video game players completed a series of questionnaires online. While MMORPG players reported increased rates of problematic use and life interference compared with non-MMORPG players, there were no differences in levels of psychopathology. Differences between MMORPG players and non-MMORPG players appeared to be associated with the increased amounts of time that MMORPG players played for: The amount of time spent playing appeared to mediate the relationships between type of game played and each of the problematic use and life interference variables. The implications of these findings are discussed.
Rosenbaum, S, Tiedemann, A, Berle, D, Ward, PB & Zachary, S 2015, 'Exercise as a novel treatment option to address cardiometabolic dysfunction associated with PTSD.', Metabolism: clinical and experimental, vol. 64, no. 5, pp. e5-e6.View/Download from: Publisher's site
Berle, D, Starcevic, V, Milicevic, D, Hannan, A, Dale, E, Brakoulias, V & Viswasam, K 2015, 'Do Patients Prefer Face-to-Face or Internet-Based Therapy?', PSYCHOTHERAPY AND PSYCHOSOMATICS, vol. 84, no. 1, pp. 61-62.View/Download from: Publisher's site
Brakoulias, V, Starcevic, V, Berle, D, Milicevic, D, Hannan, A, Viswasam, K & Mann, K 2014, 'The clinical characteristics of obsessive compulsive disorder associated with high levels of schizotypy', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, vol. 48, no. 9, pp. 852-860.View/Download from: UTS OPUS or Publisher's site
Berle, D & Moulds, ML 2014, 'Intrusion-based reasoning and depression: Cross-sectional and prospective relationships', MEMORY, vol. 22, no. 7, pp. 770-783.View/Download from: UTS OPUS or Publisher's site
Brakoulias, V, Starcevic, V, Berle, D, Milicevic, D, Hannan, A & Martin, A 2014, 'The Relationships Between Obsessive-Compulsive Symptom Dimensions and Cognitions in Obsessive-Compulsive Disorder', PSYCHIATRIC QUARTERLY, vol. 85, no. 2, pp. 133-142.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Monti, MR, D'Agostino, A & Berle, D 2013, 'Will DSM-5 make us feel dysphoric? Conceptualisation(s) of dysphoria in the most recent classification of mental disorders', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, vol. 47, no. 10, pp. 954-955.View/Download from: Publisher's site
Brakoulias, V, Starcevic, V, Berle, D, Milicevic, D, Moses, K, Hannan, A, Sammut, P & Martin, A 2013, 'The characteristics of unacceptable/taboo thoughts in obsessive-compulsive disorder', COMPREHENSIVE PSYCHIATRY, vol. 54, no. 7, pp. 750-757.View/Download from: UTS OPUS or Publisher's site
Berle, D & Moulds, ML 2013, 'An experimental investigation of emotional reasoning processes in depression', BRITISH JOURNAL OF CLINICAL PSYCHOLOGY, vol. 52, pp. 316-329.View/Download from: UTS OPUS or Publisher's site
Brakoulias, V, Starcevic, V, Berle, D, Sammut, P, Milicevic, D, Moses, K, Hannan, A & Martin, A 2013, 'Further Support for Five Dimensions of Obsessive-Compulsive Symptoms', JOURNAL OF NERVOUS AND MENTAL DISEASE, vol. 201, no. 6, pp. 452-459.View/Download from: UTS OPUS or Publisher's site
Berle, D & Moulds, ML 2013, 'Emotional Reasoning Processes and Dysphoric Mood: Cross-Sectional and Prospective Relationships`', PLOS ONE, vol. 8, no. 6.View/Download from: UTS OPUS or Publisher's site
Brakoulias, V, Starcevic, V, Berle, D, Milicevic, D, Moses, K, Hannan, A, Sammut, P & Martin, A 2013, 'The use of psychotropic agents for the symptoms of obsessive-compulsive disorder', AUSTRALASIAN PSYCHIATRY, vol. 21, no. 2, pp. 117-121.View/Download from: UTS OPUS or Publisher's site
Starcevic, V & Berle, D 2013, 'Cyberchondria: towards a better understanding of excessive health-related Internet use', EXPERT REVIEW OF NEUROTHERAPEUTICS, vol. 13, no. 2, pp. 205-213.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Berle, D, Brakoulias, V, Sammut, P, Moses, K, Milicevic, D & Hannan, A 2013, 'Obsessive-compulsive personality disorder co-occurring with obsessive-compulsive disorder: Conceptual and clinical implications', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, vol. 47, no. 1, pp. 65-73.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Berle, D, Brakoulias, V, Sammut, P, Moses, K, Milicevic, D & Hannan, A 2012, 'Interpersonal reassurance seeking in obsessive-compulsive disorder and its relationship with checking compulsions', PSYCHIATRY RESEARCH, vol. 200, no. 2-3, pp. 560-567.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Sammut, P, Berle, D, Hannan, A, Milicevic, D, Moses, K, Lamplugh, C & Eslick, GD 2012, 'Can levels of a general anxiety-prone cognitive style distinguish between various anxiety disorders?', Comprehensive psychiatry, vol. 53, no. 5, pp. 427-433.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The question of whether certain anxiety disorders are especially related to a cognitive style characterized by an exaggerated perception of threat and appraisal of the future as excessively unpredictable (general anxiety-prone cognitive style) remains open. OBJECTIVES: This study aimed to compare patients with generalized social anxiety disorder (SAD), generalized anxiety disorder (GAD), panic disorder with agoraphobia (PDA), and panic disorder without agoraphobia (PD) in terms of the levels of general anxiety-prone cognitive style when the severity of general distress and psychopathology is controlled for and to ascertain whether a co-occurring depressive disorder contributes substantially to the levels of this cognitive style. METHODS: The Anxious Thoughts and Tendencies Scale, a measure of a general anxiety-prone cognitive style, and Symptom Checklist 90-Revised were administered to 204 patients with various anxiety disorders who attended an outpatient anxiety disorders clinic and were diagnosed based on a semistructured diagnostic interview. RESULTS: Patients with principal diagnoses of SAD and GAD had a more prominent general anxiety-prone cognitive style than patients with principal diagnoses of PD and PDA when the severity of general distress and psychopathology was controlled for. The presence or absence of a co-occurring depressive disorder had no bearing on this finding. CONCLUSIONS: The general cognitive component characterizes SAD and GAD more than it does PD and PDA, and a co-occurring depressive disorder does not affect this finding. These results have implications for distinguishing between various anxiety disorders.
Berle, D, Starcevic, V, Brakoulias, V, Sammut, P, Milicevic, D, Hannan, A & Moses, K 2012, 'Disgust propensity in obsessive-compulsive disorder: Cross-sectional and prospective relationships', JOURNAL OF BEHAVIOR THERAPY AND EXPERIMENTAL PSYCHIATRY, vol. 43, no. 1, pp. 656-663.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Berle, D, Brakoulias, V, Sammut, P, Moses, K, Milicevic, D & Hannan, A 2011, 'The nature and correlates of avoidance in obsessive-compulsive disorder', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, vol. 45, no. 10, pp. 871-879.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Berle, D, Porter, G & Fenech, P 2011, 'Problem Video Game Use and Dimensions of Psychopathology', INTERNATIONAL JOURNAL OF MENTAL HEALTH AND ADDICTION, vol. 9, no. 3, pp. 248-256.View/Download from: UTS OPUS or Publisher's site
Brakoulias, V, Starcevic, V, Sammut, P, Berle, D, Milicevic, D, Moses, K & Hannan, A 2011, 'Obsessive-compulsive spectrum disorders: a comorbidity and family history perspective', AUSTRALASIAN PSYCHIATRY, vol. 19, no. 2, pp. 151-155.View/Download from: UTS OPUS or Publisher's site
Berle, D, Starcevic, V, Moses, K, Hannan, A, Milicevic, D & Sammut, P 2011, 'Preliminary Validation of an Ultra-brief Version of the Penn State Worry Questionnaire', CLINICAL PSYCHOLOGY & PSYCHOTHERAPY, vol. 18, no. 4, pp. 339-346.View/Download from: UTS OPUS or Publisher's site
Starcevic, V, Berle, D, Brakoulias, V, Sammut, P, Moses, K, Milicevic, D & Hannan, A 2011, 'Functions of compulsions in obsessive-compulsive disorder', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, vol. 45, no. 6, pp. 449-457.View/Download from: UTS OPUS or Publisher's site
Berle, D, Starcevic, V, Milicevic, D, Hannan, A & Moses, K 2010, 'Do Symptom Interpretations Mediate the Relationship Between Panic Attack Symptoms and Agoraphobic Avoidance?', BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPY, vol. 38, no. 3, pp. 275-289.View/Download from: Publisher's site
Porter, G, Starcevic, V, Berle, D & Fenech, P 2010, 'Recognizing problem video game use', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, vol. 44, no. 2, pp. 120-128.View/Download from: Publisher's site
Berle, D, Starcevic, V, Milicevic, D, Moses, K, Hannan, A, Sammut, P & Brakoulias, V 2010, 'The Factor Structure of the Kessler-10 Questionnaire in a Treatment-Seeking Sample', JOURNAL OF NERVOUS AND MENTAL DISEASE, vol. 198, no. 9, pp. 660-664.View/Download from: Publisher's site
Starcevic, V, Berle, D, Fenech, P, Milicevic, D, Lamplugh, C & Hannan, A 2009, 'Distinctiveness of perceived health in panic disorder and relation to panic disorder severity', Cognitive Therapy and Research, vol. 33, no. 3, pp. 323-333.View/Download from: Publisher's site
The aims of this study were to investigate to what extent perceived health in panic disorder (PD) is distinct from related constructs and to examine the relationship between perceived health and various domains of PD severity. Seventy-five PD outpatients were administered instruments measuring perceived health, anxiety sensitivity, hypochondriacal fears and beliefs, catastrophic appraisals of the consequences of physical symptoms of anxiety and panic, various aspects of psychopathology, and PD severity. Results of the correlation, partial correlation, and multiple regression analyses suggest the following: (1) among PD patients there is much overlap between negatively perceived health, catastrophic appraisals of the consequences of physical symptoms of anxiety and panic, and hypochondriacal beliefs; (2) negatively perceived health is not significantly related to PD severity nor to any aspect of PD severity, whereas anxiety sensitivity and hypochondriacal beliefs have a significant relationship with the severity of anticipatory anxiety, and in that regard may be more clinically useful than perceived health before the beginning of treatment. © 2008 Springer Science+Business Media, LLC.
Berle, D, Starcevic, V, Hannan, A, Milicevic, D, Lamplugh, C & Fenech, P 2008, 'Cognitive factors in panic disorder, agoraphobic avoidance and agoraphobia.', Behaviour research and therapy, vol. 46, no. 2, pp. 282-291.View/Download from: Publisher's site
There remains a lack of consensus regarding the possibility that especially high levels of panic-related cognitions characterise panic disorder with agoraphobia. We administered the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire and the Anxious Thoughts and Tendencies Scale as well as measures of agoraphobic avoidance to patients diagnosed with panic disorder with agoraphobia (n=75) and without agoraphobia (n=26). Patients with panic disorder with agoraphobia did not score significantly higher on any of the cognitive variables than did panic disorder patients without agoraphobia. However, most of the cognitive variables showed small to moderate-strength correlations with self-report measures of agoraphobic avoidance. Our findings suggest that anxiety sensitivity, catastrophising of the consequences of panic and a general anxiety-prone cognitive style, although to some extent associated with agoraphobic avoidance, do not discriminate panic disorder with agoraphobia from panic disorder without agoraphobia.
Lamplugh, C, Berle, D, Milicevic, D & Starcevic, V 2008, 'A pilot study of cognitive behaviour therapy for panic disorder augmented by panic surfing.', Clinical psychology & psychotherapy, vol. 15, no. 6, pp. 440-445.View/Download from: Publisher's site
This pilot study reports the outcome of cognitive behaviour therapy for panic disorder augmented by panic surfing. This treatment approach encourages acceptance of feelings rather than control of symptoms and anxiety, at the same time also targeting catastrophic misinterpretations, bodily vigilance and safety-seeking behaviours. Eighteen participants completed a brief group treatment for panic disorder incorporating psychoeducation, panic surfing, interoceptive exposure, graded exposure and cognitive restructuring. Significant improvements occurred over the course of this treatment and were maintained at a 1-month follow-up. Results suggest that cognitive behaviour therapy augmented by panic surfing may be effective in the treatment of panic disorder, but there is a need for controlled studies and investigation of the relative contribution of its various components.
Berle, D & Starcevic, V 2007, 'Inconsistencies between reported test statistics and p-values in two psychiatry journals', INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, vol. 16, no. 4, pp. 202-207.View/Download from: Publisher's site
Starcevic, V, Latas, M, Kolar, D & Berle, D 2007, 'Are there gender differences in catastrophic appraisals in panic disorder with agoraphobia?', Depression and anxiety, vol. 24, no. 8, pp. 545-552.View/Download from: Publisher's site
Our aim in this study was to compare panic-related catastrophic appraisals between women and men with panic disorder with agoraphobia (PDA). One hundred two outpatients with PDA (75 women and 27 men) participated. Two instruments for the assessment of catastrophic appraisals, Agoraphobic Cognitions Questionnaire and Panic Appraisal Inventory, were administered before and after cognitive-behavioral therapy (CBT) that also included pharmacotherapy in three-fourths of the patients. Female and male patients did not differ significantly in terms of their tendency to anticipate catastrophic consequences of panic, before or after CBT-based treatment. For both females and males, the tendency to make catastrophic appraisals decreased significantly with treatment. We conclude that among patients with PDA there are no gender differences in catastrophic appraisals of panic sensations and symptoms. The apparently higher risk of panic recurrence in women does not seem to be related to their panic-related catastrophic appraisals. These findings also support a notion that there is no gender difference in response to CBT-based treatment of PDA.
Starcevic, V, Berle, D, Milicevic, D, Hannan, A, Lamplugh, C & Eslick, GD 2007, 'Pathological worry, anxiety disorders and the impact of co-occurrence with depressive and other anxiety disorders', JOURNAL OF ANXIETY DISORDERS, vol. 21, no. 8, pp. 1016-1027.View/Download from: Publisher's site
Berle, D 2007, 'Graded exposure therapy for long-standing disgust-related cockroach avoidance in an older male', Clinical Case Studies, vol. 6, no. 4, pp. 339-347.View/Download from: UTS OPUS or Publisher's site
This case study outlines the use of graded in-vivo exposure to reduce an aversion to cockroaches in an older male. Following assessment, seven therapy sessions of in-vivo exposure were conducted where the client was progressively brought into closer and closer contact with cockroaches. A decrease in the client's aversion to cockroaches was apparent at posttreatment and persisted to 5-month follow-up, as evidenced by client reports and decreased behavioral avoidance. The client maintained that his avoidance had been driven by disgust, rather than fear, and the reduction of his avoidance of and aversion to cockroaches indicates that approaches developed for fearful clients may also be effective for clients who do not report fear responses to their avoided stimuli. © 2007 Sage Publications.
Berle, D, Blaszczynski, A, Einstein, DA & Menzies, RG 2006, 'Thought-action fusion in schizophrenia: A preliminary investigation', BEHAVIOUR CHANGE, vol. 23, no. 4, pp. 260-269.View/Download from: Publisher's site
Berle, D & Phillips, ES 2006, 'Disgust and obsessive-compulsive disorder: An update', PSYCHIATRY-INTERPERSONAL AND BIOLOGICAL PROCESSES, vol. 69, no. 3, pp. 228-238.View/Download from: Publisher's site
Brodaty, H, Berle, D, Hickie, I & Mason, C 2003, 'Perceptions of outcome from electroconvulsive therapy by depressed patients and psychiatrists', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, vol. 37, no. 2, pp. 196-199.View/Download from: Publisher's site
Berle, D 2003, 'The influence of withdrawal symptoms and catastrophic thinking on smokers' self-efficacy', Addictive Disorders and their Treatment, vol. 2, no. 3, pp. 97-104.View/Download from: Publisher's site
Objectives: This is a correlational study examining the relationships between reported withdrawal symptoms, catastrophic thinking about symptoms, general catastrophic thinking, self-efficacy concerning temptation, and self-efficacy concerning relapse. Methods: 83 university student smokers completed self-report questionnaires. Results: It was hypothesized that a greater expectation of withdrawal symptoms would be related to lower self-efficacy; it was found that the withdrawal symptom score was correlated with temptation self-efficacy, but not relapse self-efficacy. It was hypothesized that catastrophizing about withdrawal symptoms would be related to lower self-efficacy; when withdrawal symptoms were controlled for, only relapse self-efficacy was predicted by symptom catastrophizing. It was hypothesized that a general tendency to catastrophize life events would predict low self-efficacy; this was found not to be the case. Conclusions: The differing pattern of results for temptation and relapse self-efficacy emphasize the need to distinguish between the two when researching this area. Copyright © 2003 Lippincott Williams & Wilkins, Inc.
Hilbrink, D, Berle, D & Steel, Z 2016, 'Pathways to posttraumatic stress disorder.' in Trauma-related stress in Australia: Essays by leading Australian thinkers and researchers., Australia 21, Weston, ACT, pp. 22-26.View/Download from: UTS OPUS
Many descriptions and formulations of Post Traumatic
Stress Disorder have presented trauma as an experience of
intense threat-fear-terror that can (for some) cause lasting
psychological injury. This does not capture the full range of
traumatising experience that we see clinically and some people do
not respond to treatments designed to address fear-threat-terror.
We are therefore incorporating the growing literature on moral injury
and the valuable model of psychosocial pillars into a more inclusive
pathways model that highlights the significance of experiences of
horror-shock-injustice-guilt in traumatic injury and the need for
this to be accounted for in treatment. We believe that broadening
our conceptualisation of PTSD in these ways will serve to better
inform the provision of services for people with PTSD as well as
help to articulate what clinicians have always implicitly understood.
Rosenbaum, S, Ward, P, Fogarty, A, Berle, D, Boydell, K, Lappin, J & Steel, Z 2017, 'IMPLEMENTING PHYSICAL ACTIVITY IN PTSD: APPLYING EVIDENCE-BASED PROGRAMS FOR WORKPLACE-RELATED PSYCHOLOGICAL INJURIES', ANNALS OF BEHAVIORAL MEDICINE, SPRINGER, pp. S416-S417.