In the face of horror – secondary traumatisation and mental distress in employees and volunteers at national socialism related memorial sites

Also in the present study among German-speaking participants, general mental distress was high. Scores were higher after than during the lockdown, indicating an ongoing destabilization for a significant part of the population. People who saw a meaning in their lives and who were capable of self-control reported substantially less mental distress. Meaningfulness and self-control also served as buffers between COVID-19 stress and general mental distress: When COVID-19 stress was high, the presence of meaningfulness and self-control accounted for lower general mental distress. Moreover, people who suffered strongly from COVID-19 stress were more likely to develop a crisis of meaning which, in turn, was associated with higher general mental distress. This suggests that ongoing anxiety and depression might (also) be based on existential struggles. Again here, self-control buffered the impact of crisis of meaning on general mental health. We conclude from these findings that public health policies can support citizens in coping with large-scale crises by enabling experiences of meaningfulness, e.g., through transparent and reliable modes of communicating goals and necessary intermediate steps. Moreover, health professionals are well advised to invite individuals to confront existential questions and struggles, and to encourage them to exercise self-control. The latter can be boosted by keeping higher-order goals salient-which again is inherently linked to an understanding of their meaning.

Political tension, as expressed by mass movements such as the Occupy Central movement (2014) in Hong Kong, is a potential but understudied structural factor of population mental health. A random population-based telephone survey anonymously interviewed 344 Hong Kong Chinese adults aged 18-65years during the 2weeks since the termination date of the 2-month-long Occupy Central movement (15/12/2014). Linear regression models were fit using mental distress (depression, anxiety and negative mood) and self-perceived changes in mood/sleeping quality as dependent variables. Prevalence of participation in the movement was 10.5% (self), 17.7% (family members/relatives), and 34.0% (peers); 8.5% had participated for ≥2days. Young age, but not participation, was associated with mental distress. In adjusted analysis, three types of responses to the movement (worry about safety, negative emotional responses to media reports, and conflicts with peers about the movement) and emotional responses to local political situations were significantly associated with all/some of the dependent variables related to mental distress. The variable on emotions toward local political situations was correlated with the three responses to the movement; it fully mediated the associations between such responses and mental distress. Many citizens participated in the movement, which was led by youths and might have increased the general public's mental distress. Negative personal responses to the movement and emotions toward political situations were potential risk factors. As the political tension would last and political pessimism is globally found, politics may have become a regular and persistent structural risk factor negatively affecting population mental health.

ABSTRACTLimited research has examined the contributions of sport-specific family relationship problems to athlete mental health. In the current study we examined the extent to which collegiate athletes’ family problems (as measured by the Student Athlete Relationship Instrument factors, SARI) predict athletes’ general mental health distress and specific mental health symptoms that are relatively common in athletes (i.e. depression, anxiety, and drug and alcohol use). The study included 85 collegiate athletes (intramural, n = 26; club sport, n = 12; NCAA Division I, n = 47). We hypothesized that both general mental health distress and commonly evidenced mental health symptoms would be predicted by athletes’ responses to the SARI factors (Poor Relationship and Lack of Support, General Pressure, Pressure to Quit or Continue Unsafely, Embarrassing Comments, and Negative Attitude). Results indicated that all of the aforementioned SARI factors predicted athletes’ ratings of depression and general mental health distress levels. Only the General Pressure SARI factor predicted athletes’ anxiety and drug use. Alcohol use was not predicted by any of the SARI factors. Receiver operating characteristic (ROC) analyses indicated that sport-specific problems in family relationships provided a good classification of athletes at risk for general mental health distress, depression, and anxiety. Practice implications are discussed in light of the results.

To determine whether caring for a child with mental health issues could lead to mental distress among mothers. Cross-sectional study. Outpatient Clinics of The Aga Khan University Hospital and PNS Shifa Hospital, Karachi, from January to June 2005. A total of 238 consecutive mothers bringing their children to child psychiatric and pediatric clinics were recruited over a 6-month period. As per inclusion criteria, 106 mothers of child psychiatric patients were compared to 132 mothers taken from pediatric clinics. They were asked to fill out a psychiatric screening instrument (WHO SRQ-20). Mothers' mental distress (score>or=10 on SRQ-20) and other potential risk or protective factors were measured. Mental distress among mothers determined by WHO SRQ-20 was associated with their child attending a psychiatric clinic (odds ratio 2.51, 95% confidence interval 1.38-4.51). This association remained significant for age of mother being less than 30 years. No significant association was found with the number of children and duration of marriage. Mental distress among mothers is associated with the child having psychiatric problems. These mothers may represent a group who are at higher risk of depression. Early recognition and treatment of mental health problems in mothers may help reduce psychiatric morbidity in children.

Maintaining good mental health is important during a crisis. However, little attention has been given to how people achieve this, or how they evaluate emotions associated with stressors, such as the COVID-19 pandemic. This study aims to (1) investigate whether emotion regulation, in particular cognitive reappraisal and suppression, moderates the relationship between COVID-19 stress and general mental distress and (2) examine gender differences in the interrelations between COVID-19 stress, emotion regulation, and mental distress. Data from a population in Norway (n = 1.225) were collected using a cross-sectional survey during the early months of the COVID-19 pandemic. Emotion regulation was measured using the Emotion Regulation Questionnaire Scale (ERQ), COVID-19 stress with the COVID-19 Stress Scale, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS. There was a strong association between COVID-19 stress and general mental distress (r = 0.61). The moderation analyses showed substantial moderation effects of cognitive reappraisal and suppression on the relationship between COVID-19 stress and mental distress. Cognitive reappraisal served as a buffer (p = 0.001) and suppression (p = 0.002) exacerbated the relation between COVID-19 stress and mental distress. Men had higher scores of suppression (p < 0.001), and women had higher scores of cognitive reappraisal (p = 0.025). The buffering effect of cognitive reappraisal presented itself only in women (p < 0.001), while the exacerbation effect of suppression appeared only in men (p < 0.001). The current study suggests that COVID-19 pandemic-related stress is easier to deal with for those who have the tendency to cognitively reappraise. In contrast, suppression is associated with symptoms of depression and anxiety. The prevention of mental distress can be supported by guiding people about the importance of using healthy emotion regulation strategies, as well as helping them to become more aware of the way they interpret and regulate their emotions. Gender differences in emotion regulation suggest gender awareness, e.g., tailored programs for men and women.

Mothers' mental health and life satisfaction may have been negatively affected due to challenges during the COVID-19 pandemic. Given the risk of future crises, knowledge of possible mitigating factors in this population is essential. This study aims to examine whether the pandemic affected the level of protective factors such as social support, physical activity and employment situation, and how these factors are associated with mental distress and life satisfaction. Longitudinal cohort study. Primary outcomes were mental distress (measured by the eight-item version of the Hopkins Symptom Checklist) and life satisfaction (measured by the Satisfaction With Life Scale). As the first step, we investigated changes in the levels of social support (defined by the number and frequency of social contact), physical activity (average hours of physical activity during a week), employment situation (actively working vs sick leave or unemployed), alcohol consumption (measured by the Alcohol Use Disorders Identification Test-Consumption) and relationship satisfaction (measured by the five-item version of the Relationship Satisfaction Scale). We analysed data from two waves of the Norwegian Mother, Father and Child Cohort Study (n=~18 000 mothers); one pre-pandemic wave and one wave where half of the sample responded after the onset of the pandemic, with pandemic exposure being defined by questionnaire response timing rather than cohort recruitment. To assess changes in protective factors over time and pandemic exposure, we used difference-in-differences analyses and regression discontinuity design. Associations between protective factors with mental distress and life satisfaction, and possible moderation by pandemic exposure, were investigated using multiple regression models with interaction terms adjusted for potential confounders. Apart from physical activity, which declined less across time in the pandemic group (B=0.09, 99% CI 0.05 to 0.12), protective factors did not change during the pandemic. Social support, employment situation and relationship satisfaction were associated with mental distress and life satisfaction, whereas physical activity showed a unique relationship with mental distress. Most associations were similar across pandemic exposure groups, except employment situation which appeared to have a stronger protective effect in the pandemic group (β=-0.12, 99% CI -0.24 to -0.00). Changes over time in self-reported levels of protective factors were generally consistent among mothers independent of the pandemic. These factors appear to play an equally important role for mental distress and life satisfaction both under ordinary circumstances and during public health crises. Our findings enhance the understanding of how potential protective factors among mothers are associated with mental distress and life satisfaction in the context of a global stressor. Future studies should investigate additional mitigating factors that may be particularly relevant during global crises and explore the causal relationship between protective factors, mental health and life satisfaction.

BackgroundAn internal locus of control (LoC I) refers to the belief that the outcome of events in one’s life is contingent upon one’s actions, whereas an external locus of control (LoC E) describes the belief that chance and powerful others control one’s life. This study investigated whether LoC I and LoC E moderated the relationship between COVID-19 stress and general mental distress in the general population during the early months of the COVID-19 pandemic.MethodsThis cross-sectional survey study analysed data from a Norwegian (n = 1225) and a German-speaking sample (n = 1527). We measured LoC with the Locus of Control-4 Scale (IE-4), COVID-19 stress with a scale developed for this purpose, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS.ResultsThe association between COVID-19 stress and general mental distress was strong (r = .61 and r = .55 for the Norwegian and the German-speaking sample, respectively). In both samples, LoC showed substantial moderation effects. LoC I served as a buffer (p < .001), and LoC E exacerbated (p < .001) the relation between COVID-19 stress and general mental distress.ConclusionsThe data suggest that the COVID-19 pandemic is easier to bear for people who, despite pandemic-related strains, feel that they generally have influence over their own lives.An external locus of control, conversely, is associated with symptoms of depression and anxiety. The prevention of mental distress may be supported by enabling a sense of control through citizen participation in policy decisions and transparent explanation in their implementation.

General and COVID19-specific emotional stress: Religious practice as a potential coping strategy

Mental illnesses affect almost 15% of the world’s population, with half of the cases emerging before age 14. Improved methods for predicting mental distress among adolescents, particularly in vulnerable populations, are needed. This study utilized traditional machine learning techniques to predict mental health status at age 17. We assessed the correlates of mental health outcomes in a sample of 632 adolescents with general mental distress (i.e., total difficulties score of 17 or higher) at age 11, who participated in the UK Millennium Cohort Study. Predictors measured at ages 11 and 14 were included in the analysis. Mental health status at age 17 was best predicted using a Balanced Random Forest model (AUC 0.75). Explainability techniques enabled the identification of several critical factors, such as school environment, emotional distress, sleep patterns, patience, and social network at ages 11 or 14, which were able to differentiate participants with poor or good mental health outcomes at age 17. Individuals experiencing persistent mental distress between the ages 11 and 17 were most likely to suffer from unhappiness and academic struggles. Our results point to potentially modifiable factors associated with the progression of mental distress in adolescents at high risk. These factors could pave the way for improved early intervention and preventive strategies for vulnerable young people during adolescence.

This study aimed to use a large population-based sample to investigate age-associated differences in mental distress among sexual and gender minority (SGM) adults compared with their heterosexual, cisgender counterparts. Data were pooled from five cycles (2014-2018) of the Behavioral Risk Factor Surveillance System (BRFSS) survey (N=762,541) and included states that administered the optional SGM module during that interval. Mean days of self-reported mental distress and the rate of frequent mental distress (≥14 days of mental distress per month) were calculated for each age and SGM identity stratum by using linear and logistic regression, respectively. Models controlled for socioeconomic factors and medical comorbid conditions. All analyses accounted for the complex survey design of the BRFSS. Among those ages 18-24 years, mean days of mental distress and the rate of frequent mental distress were significantly higher for SGM subgroups compared with cisgender, heterosexual adults. Among those ages 45-54, 55-64, or ≥65, no differences were noted between SGM groups and their cisgender, heterosexual peers. Younger SGM respondents reported the highest levels of mental distress. Differences in general mental distress were less detectable with increasing age. The findings suggest that SGM young adults have an increased need for mental health services.

Secondary trauma is recognised as one of the negative effects for professionals working with people that have experienced trauma. Research has demonstrated secondary trauma in foster carers but little research has explored trauma symptoms within adoptive parents, facing the emotional impact of parenting a child with adverse early experiences. This study aimed to document the rates of primary and secondary trauma symptoms in adoptive parents. It further explores the association between the extent of current behavioural and emotional challenges and the extent of the child's pre-adoption adverse experiences in predicting parental trauma responses. 190 adoptive parents completed an online survey including self-report measures of primary and secondary trauma. Almost one fifth of adoptive parents exhibited primary trauma scores of clinical concern; with 10% reaching the threshold for a probable diagnosis of PTSD. Participants also reported significantly higher levels of secondary trauma and burnout, and significantly lower levels of compassion satisfaction than population norms. The current behavioural and emotional challenges, including child-to-parent violence, predicted higher trauma scores more so than the extent of their child's past adverse experiences. The findings have clinical implications for identifying trauma symptoms within adoptive parents and wider implications for how we understand secondary and primary trauma. They further highlight the importance of firstly addressing current child behaviour, including child-to-parent violence when treating trauma symptoms. Limitations of this study and recommendations for further research are discussed.

The devastation of the Covid-19 pandemic on society raised the question of how best to gauge society’s psychological adaptation to continually evolving global disruptor events, such as Covid-19. This paper aims to illustrate the use of different approaches to monitor society’s psychological response to Covid-19, in order to argue for a more comprehensive, multi-model, approach. The results from different approaches are presented in two studies employing measures of mental disorders and mental distress, respectively, using South African samples for demonstration. The first study presents findings from repeat administration of measures of common mental disorders (major depressive and generalized anxiety disorders) across three consecutive years, while the second study presents findings from mood response profiles (measured with the Brunel Mood Scale) collected across five time points during the Covid-19 pandemic. Both studies showed that the Covid-19 pandemic was temporally associated with adverse mental health outcomes across the mental health continuum, and that mental health profiles were associated with both time since onset of Covid-19 and subsequent wave occurrence. Elevated prevalence of common mental disorders, as well as fluctuating patterns of mood response profiles, are discussed against the context of Covid-19. The paper concludes that a multi-modal approach, for instance measuring specific mental disorders as well as more general mental distress, is crucial to comprehensively understand society’s psychological adaptation to major disruptor events, and guide health sector responses. The paper serves as a reminder to continue to observe mental health more inclusively to appropriately respond to the psychological needs of communities.

BackgroundReactions to the COVID-19 pandemic are diverse, and both mental distress and existential crises can arise. The identification of protective and exacerbating factors and their progress over time is therefore highly relevant. The current study examined longitudinal protective effects of meaningfulness and exacerbating effects of crisis of meaning on general mental distress.MethodsN = 431 participants from Germany and Austria (mean age: 42 years) completed an online survey in both April/May (T1) and July/August 2020 (T2). After determining temporal stability or changes in meaningfulness, crisis of meaning, and general mental distress (PHQ-4), we examined whether (i) meaningfulness and (ii) crisis of meaning, measured at T1, incrementally predicted PHQ-4 at T2, beyond baseline levels of PHQ-4. We further tested (iii) a within-subject mediation of temporal changes in PHQ-4 by changes in crisis of meaning.ResultsMeaningfulness prospectively predicted lower PHQ-4, and crisis of meaning predicted higher PHQ-4. From the first wave of the pandemic until a slowdown three months later, meaningfulness was stable, and crisis of meaning and PHQ-4 decreased. Changes in crisis of meaning mediated the changes in PHQ-4.ConclusionsMeaningfulness appears to have a protective, and crisis of meaning an exacerbating effect on psychological distress, as shown here for the time of the first pandemic wave until three months later. Attention to existential experiences of meaningfulness and loss of meaning thus proves relevant to the clinical and public health context. Measures that support meaningfulness will help coping with crises of meaning, which in turn supports overcoming general mental distress.

Introduction: Mental health of workers is an essential determinant of their workproductivity and their overall health. Poor mental health contributes meaningfully to arange of chronic physical illnesses such as hypertension, diabetes, and cardiovasculardisorders. Besides, mental health distress can severely impact the ability to work,leading to increased absenteeism and/or presenteeism. Consequently, employers andbusinesses are negatively affected by poor mental health among their employees due tothe lost productivity and profits, as well as the increased direct costs of managing thesehealth problems. Aim of work: To investigate the association between mental healthdistress and work productivity in terms of absenteeism and presenteeism. Materialsand Methods: One-hundred and eighty male shipyard-workers were interviewed usinga predesigned questionnaire for sociodemographic characteristics, work characteristics,lifestyle behaviors, perceived health status, and chronic diseases. Mental health distresswas measured using the Kessler psychological distress scale (K6), while measuresof work productivity (absenteeism and presenteeism) were calculated according tothe scoring guide of the Health and Work Performance Questionnaire (HPQ-shortform). Results: The mean age of participants was 48.3 years (± 8.17). Operators and service-workers constituted 73.3% of all participants, while professionals andadministrative workers represented 16.7% and 10%, respectively. Eight workers (4.4%)had high mental health distress, while 12.2% had moderate distress. The mean daysof absenteeism and presenteeism were significantly higher among participants withmoderate or high mental distress compared to low distress (p < 0.001). Further, withineach level of mental distress, the mean presenteeism days were significantly higher thanthe mean absenteeism days. Moderate and high mental distresses were associated with2.1 and 3.9 times greater rates of absenteeism and presenteeism compared to low mentaldistress. Conclusion: Mental health distress is associated with both higher absence andpresenteeism rates. Effective workplace policies for mental health promotion and casemanagement could yield substantial increases in worker’s productivity.

Previous studies have observed high mental distress in individuals with gender dysphoria (GD). A deeper investigation on constructs underlying mental distress in this specific population is warranted, given the high burden of neglected health needs. To assess mental pain levels in individuals with GD, compared to a control group, and to evaluate potential psychological correlates. In this case-control study, 180 individuals were enrolled between January 2020 and January 2024 (94 individuals with GD and 86 controls). All participants completed the following questionnaires: Identity and Eating disorders questionnaire, Orbach & Mikulincer Mental Pain scale, Symptom CheckList 90 - Revised, Beck Depression Inventory II. Among participants with GD, 39 were undergoing gender affirming hormone therapy (GAHT) while 55 were not. Individuals with GD showed significantly higher levels of mental pain than those in the control group (Cohen's d = 0.318, p < 0.001). Positive correlations emerged between mental pain and general mental distress (r = .559, p < .001), depression (r = .828, p < .001), or embodiment disturbances (r = .582, p < .001). Individuals with GD undergoing GAHT for at least one year showed lower levels of mental pain than those seeking GAHT, but not exposed to GAHT at the time of evaluation (Cohen's d = 0.571, p < .001). Mental pain is elevated in individuals with GD, with specific correlates related to mental distress, depression, and embodiment disturbances. Preliminary evidence suggests that GAHT may reduce levels of mental pain in individuals with GD.