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Addressing stereotype treatment bias in medical education

Cognitive Bias Modification for Stereotype Bias in Medical Education

This research applies Cognitive Bias Modification principles to medical education to examine whether implicit stereotype bias among medical students can be reduced through targeted digital training called Cognitive Bias Modification-Stereotype (CBM-S).

The programme has developed intervention materials addressing stereotypes relevant to diverse populations and is extending this work across different groups in Aotearoa New Zealand, including Māori, Asian, Pasifika, Rainbow, disability, and older-person populations.

The research aims to develop practical, scalable approaches for addressing cognitive biases that may influence healthcare professionals' perceptions and decision-making, ultimately contributing to more equitable and culturally responsive healthcare.

Key researchers:

Dr Jerry Hsu
Department of Psychological Medicine, Dunedin

Dr Chris Lin
Department of Psychological Medicine, Dunedin
Email chris.lin@otago.ac.nz

Are you intersted in becoming a participant?

We are looking for collaborators from the various communities (Māori, Asian, Pasifika, Rainbow, disability, and older-person populations) and medical educators and professionals. We also welcome collaborators who are interested in developing this training for other communities.

Email jerry.hsu@otago.ac.nz


Improving health outcomes through benchmarking and screening tools

Developing a framework for Screening for Older adults’ Abuse Risk

This study aimed to identify key physical and psychosocial variables associated with AOP and to inform the development of a concise, evidence-based screening tool for use in Aotearoa New Zealand.

Key researchers:

Associate Professor Yoram Barak
Department of Psychological Medicine, Dunedin

Ms Linda Hobbs
Department of Psychological Medicine, Dunedin


Lonely Deaths in New Zealand

Analysis of Coronial Data

Lonely deaths—defined as deaths occurring alone and remaining undiscovered—have been increasingly reported internationally, yet their burden in New Zealand has not previously been estimated.

Key researchers:

Associate Professor Yoram Barak
Department of Psychological Medicine, Dunedin

Dr Ben Stegmann
Department of Psychological Medicine, Dunedin
Email ben.stegmann@otago.ac.nz


Screening for Abuse of Older People (AOP)

Designing and validating a novel screening tool

We propose to develop and validate a brief AOP screening tool for use by General Practitioners (GPs), ED and Non-Governmental Organisations (NGO) staff to rapidly identify older adults at high-risk of abuse in NZ.

The development of a brief-screening tool will be informed by and based on the SOAR Framework. The research team will develop a set of questions answered using Likert scoring and will complete an experts review to substantiate the tool’s construct-validity before validation commences. Validation will compare the brief-screening tool to the closest we have to a ‘gold standard’ screening tool, the ED-Senior AID. Both these measures will be used in parallel for AOP screening in two public hospitals in NZ, Dunedin and Middlemore, and in an Australian site in Melbourne. The screening will be carried out by health professionals at each site.

Feedback from the experts will be reviewed and used to make modifications to the brief screening tool before the validation phase. We will assess accuracy of our brief tool measured with sensitivity and specificity. With a minimum sample size of 300 we would ensure at least 30 cases of abuse are detected using the long form gold standard tool based on 10% abuse rate in population. This will allow sensitivity to be estimated with an exact binomial 95% confidence interval no larger than 73% to 98% assuming 90% sensitivity. For specificity the exact binomial 95% confidence interval will be no larger than 73% to 86% assuming 80% specificity.

Key researchers:

Professor Robin Turner
Department of Public Health, Dunedin

Professor Paul Glue
Department of Psychological Medicine, Dunedin

Are you interested in becoming a participant?

We will invite all patients >65 years admitted to medical or psychogeriatric wards in these sites to take part and complete informed consent. Given current admissions data we anticipate this will total 300-500 participants.

Email robin.turner@otago.ac.nz


Improving mental health outcomes for young people

Mental health of tamariki and rangatahi in care

Associate Professor Rapsey leads and collaborates on several studies focused on tamariki and rangatahi in the care of Oranga Tamariki.

Current projects include:

  1. A national study estimating the prevalence of mental health and substance-use conditions, associated impairment, and treatment need among tamariki and rangatahi in care.
  2. Research using the Integrated Data Infrastructure to understand how child maltreatment and care experiences affect health and developmental outcomes.
  3. Evaluation of interventions for tamariki in care and their whānau.

Research interests:

  • Digital interventions for mental health and sexual difficulties
  • Mental health and interventions for tamariki and rangatahi in care
  • Mental health epidemiology
  • Personalised mental healthcare

Key researcher:

Associate Professor Charlene Rapsey
Department of Pyschologyical Medicine, Dunedin


World Mental Health International College Student Initiative

Associate Professor Rapsey is the principal investigator for the World Mental Health International College Student Initiative in Aotearoa New Zealand. This international collaboration, involving Harvard Medical School and researchers across 18 countries, seeks to improve understanding and treatment of mental health difficulties among tertiary students.

The Aotearoa research programme addresses the substantial unmet need for mental healthcare among tertiary students by developing and evaluating supported online interventions and personalised approaches that match students with the level of support most likely to benefit them.

The programme comprises three integrated research streams:

  1. Development and evaluation of person-supported digital mental health interventions, including predictive tools to optimise treatment selection. This stream includes Brightside, our student-focused online programmes providing treatment for depression, anxiety, and disordered eating.
    Visit the Brightside website to learn more
  2. Qualitative research examining barriers and facilitators to treatment access, engagement, and culturally safe care among tertiary students.
  3. Longitudinal epidemiological research examining the prevalence, onset, course, impairment, and treatment of mental disorders and suicidal thoughts and behaviours.

Key researcher:

Associate Professor Charlene Rapsey
Department of Pyschologyical Medicine, Dunedin


Novel approaches for treatment-resistant conditions

Dextromethorphan plus Bupropion for Treatment-Resistant Depression

Does adding Behavioural Activation Therapy improve outcomes?

Depression is an increasing public health concern in Aotearoa New Zealand. However, around 30% of people with depression do not respond to existing antidepressant medications. There is an urgent need to identify fast-acting and effective treatment options for people with treatment-resistant depression.

This study aims to test a novel combination of two established medicines (Dextromethorphan + Bupropion) that shows potential as a treatment option for depression. This novel treatment differs from conventional antidepressants in that improvements in mood may occur more rapidly after starting treatment, typically within one to two weeks. The study also aims to evaluate whether combining Behavioural Activation Therapy with the treatment approach can further improve outcomes.

If we can show that the combination of this novel treatment and psychological therapy is successful, particularly fast and effective, we believe it has the potential to reduce the personal, social, and economic costs of mental distress in Aotearoa.

Key researchers:

Dr Neda Nasrollahi
Department of Psychological Medicine, Dunedin
Email neda.nasrollahi@otago.ac.nz

Supervisor:

Professor Paul Glue
Department of Psychological Medicine, Dunedin

Collaborators:

Emeritus Professor Neil McNaughton
Department of Psychology

Associate Professor Jenny Jordan
Department of Psychological Medicine, Christchurch

Are you interested in becoming a participant?

We are currently recruiting participants with treatment-resistant depression for this study.

Email neda.nasrollahi@otago.ac.nz


Precision Functional Mapping of the Human Brain using Resting State fMRI

Novel Treatment Validation Study Among Participants with Treatment-Resistant Social Anxiety and/or Generalised Anxiety Disorder

Anxiety is among the most common mental health disorders in New Zealand. Unfortunately, many people do not respond well to standard anxiety treatment options. Currently, there is no reliable method of identifying those who will respond to treatment, from those who will not.

Our research uses precision functional mapping, a specialised brain imaging technique that captures individual brain organisation. We aim to show that precision functional mapping can be used to accurately predict successful response to a novel anxiety treatment in participants with treatment-resistant anxiety disorders. Specifically, we will use fMRI to investigate individual brain organisation associated with anxiety improvement following treatment.

In the future, this individual brain data could be used to inform precision medicine, enabling the creation of individually tailored treatment plans.

Key researchers:

Professor Paul Glue
Department of Psychological Medicine, Dunedin

Professor Bruce Russell
School of Pharmacy and Pharmacology

Are you interested in becoming a participant?

We’re looking for people with generalized and/or social anxiety who have not responded to conventional treatment. All participants will receive a single dose of the novel treatment, that we previously reported can reduce anxiety ratings in about 70%. We want to image your brain before and after dosing. If you are a responder we can offer you further doses over 12 weeks, to help sustain this effect.

Email paul.glue@otago.ac.nz


Self-management tools for patients

Personalised Cognitive Bias Modification for Depression Using Generative AI

This research investigates whether generative AI can be used to develop personalised Cognitive Bias Modification for Interpretation (CBM-I) interventions for people experiencing depression. CBM-I targets interpretation bias, a cognitive process in which ambiguous information is more likely to be interpreted negatively.

The project examines whether AI-generated intervention materials can achieve comparable effectiveness to materials developed by human experts, while providing opportunities for greater personalisation and scalability. The research also investigates the quality, acceptability, and clinical relevance of CBM-I for depression.

The longer-term aim is to develop evidence-based digital interventions that can be delivered at scale while remaining clinically relevant and responsive to individual needs.

Key researchers:

Dr Jerry Hsu
Department of Psychological Medicine, Dunedin

Dr Chris Lin
Department of Psychological Medicine, Dunedin 
Email chris.lin@otago.ac.nz

Are you interested in becoming a participant?

We are looking for adults who have first-hand experience of depression.

Email jerry.hsu@otago.ac.nz


Quality of care in the aged-care sector

Investigating Predictors of Early Mortality in Long Term Care Facilities

An interRAI data analysis in New Zealand 2012–2022

This project aims to provide a predictive model of early mortality for older adults entering LTCF s in New Zealand.

Analysis of the mandatory assessments by the international Resident Assessment Instrument (interRAI-LTCf) dataset may provide greater insight into the variables associated with early mortality potentially providing recommendations for clinical practice or contributing for strategic planning of future services.

Key researchers:

Associate Professor Yoram Barak
Department of Psychological Medicine, Dunedin

Professor Robin Turner
Department of Public Health, Dunedin


Predictors of Early Mortality in Rest Homes

This project aims to determine the longitudinal trajectory of BPSD symptoms following the transition to LTC facilities and analyse potential contributing factors to early mortality. Analysis of the interRAI dataset may provide greater insight into the current burden and trajectory of BPSD symptoms within New Zealand’s vulnerable LTC facility cohort; potentially providing recommendations for clinical practice or contributing for strategic planning of future services.

To the best of our knowledge no project has focused on BPSD in LTC facilities in New Zealand and its association with early mortality.

Key researchers:

Professor Paul Glue
Department of Psychological Medicine, Dunedin

Associate Professor Tess Patterson
Department of Psychological Medicine, Dunedin

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