Adult Mental Health Research Articles

Young Adult Mental Health Problem Incidence Varies by Specific Combinations of Adverse Childhood Experiences

Young Adult Mental Health Problem Incidence Varies by Specific Combinations of Adverse Childhood Experiences

Prenatal exposure to air pollution and maternal depression: Combined effects on brain aging and mental health in young adulthood

IntroductionBoth maternal depression problems during pregnancy and prenatal exposure to air pollution have been associated with changes in the brain as well as worse mood and anxiety in the offspring in adulthood. However, it is not clear whether these effects are independent or whether and how they might interact and impact the brain age and mental health of the young adult offspring. MethodsA total of 202 mother–child dyads from a prenatal birth cohort were assessed for maternal depression during pregnancy through self-report questionnaires administered in the early 90s, exposure to air pollutants (Sulfur dioxide [SO2], nitrogen oxides [NOx], and suspended particle matter [SPM]) during each trimester based on maternal address and air quality data, mental health of the young adult offspring (28–30 years of age; 52% men, all of European ancestry) using self-report questionnaires for depression (Beck Depression Inventory), mood dysregulation (Profile of Mood States), anxiety (State-Trait Anxiety Inventory), and psychotic symptoms (Schizotypal Personality Questionnaire), and brain age, estimated from structural magnetic resonance imaging (MRI) and previously published neuroanatomical age prediction model using cortical thickness maps. The brain age gap estimate (BrainAGE) was computed by subtracting structural brain age from chronological age. Trajectories of exposure to air pollution during pregnancy were assessed using Growth Mixture Modeling. The interactions of prenatal depression and prenatal exposure to air pollutants on adult mental health and BrainAGE were assessed using hierarchical linear regression. ResultsWe revealed two distinct trajectories of exposure to air pollution during pregnancy: “early exposure,” characterized by high exposure during the first trimester, followed by a steady decrease, and “late exposure,” characterized by low exposure during the first trimester, followed by a steady increase in the exposure during the subsequent trimesters. Maternal depression during the first half of pregnancy interacted with NOX exposure trajectory, predicting mood dysregulation and schizotypal symptoms in young adults. In addition, maternal depression during the second half of pregnancy interacted with both NOx and SO2 exposure trajectories, respectively, and predicted BrainAGE in young adults. In those with early exposure to NOx, maternal depression during pregnancy was associated with worse mental health and accelerated brain aging in young adulthood. In contrast, in those with early exposure to SO2, maternal depression during pregnancy was associated with slower brain aging in young adulthood. ConclusionsOur findings provide the first evidence of the combined effects of prenatal exposure to air pollution and maternal depression on mental health outcomes and brain age in young adult offspring. Moreover, they point out the importance of the timing and trajectory of the exposure during prenatal development.

The Impact of COVID-19 Lockdowns on Adult Mental Health

Background Lockdowns and restrictions were introduced worldwide by governments in 2020 and 2021 in a bid to contain the spread of COVID-19. Lockdowns restricted the movement of people, whereby they could only leave their homes for essential reasons. There is yet to be a systematic review that integrates existing quantitative literature on the impact of lockdowns on mental health globally. Aim The purpose of the current study was to assess and synthesise current quantitative research on the global impact of COVID-19 lockdowns and isolation restrictions on adult mental wellbeing. The target group was adults aged 18 years and over internationally. Method Findings from 16 quantitative cross-sectional surveys and questionnaire studies from peer-reviewed journals were synthesised in this systematic literature review. Results Themes that emerged from the findings included increased depression, anxiety symptoms, and stress, and reduced social interaction and sleep quality. Conclusion The impact of COVID-19 lockdowns on mental health was evident through the shared experiences of insomnia, loneliness, physiological changes, and reduced sleep quality. An increased prevalence of depression, anxiety, and stress symptoms was common in younger adults and more so in women than men.

Experiences of individuals presenting to the emergency department for mental health reasons: A systematic mixed studies review.

Emergency departments the world over have seen substantial increases in the number of individuals presenting for mental health reasons. However, we have a limited understanding of their experiences of care. The aim of this review was to systematically examine and synthesise literature relating to the experiences of individuals presenting to emergency department for mental health reasons. We followed Pluye and Hong's seven-step approach to conducting a systematic mixed studies review. Studies were included if they investigated adult mental health experiences in emergency department from the users' perspective. Studies describing proxy, carer/family or care provider experiences were excluded. Sixteen studies were included. Thematic synthesis identified three themes and associated subthemes. Theme 1 - ED staff can make-or-break and ED experience - comprised: Feeling understood and heard; Engaging in judgement-free interactions; Receiving therapeutic support; Being actively and passively invalidated for presenting to the ED; and Once a psych patient, always a psych patient. Theme 2 - Being in the ED environment is counter-therapeutic - comprised: Waiting for an 'extremely' long time; and Lacking privacy. Theme 3 was Having nowhere else to go. The experiences described by individuals presenting to emergency department for mental health reasons were mostly poor. The results illustrate a need for increased mental health education and training for all emergency department staff. Employment of specialist and lived experience workers should also be prioritised to support more therapeutic relationships and emergency department environments. In addition, greater investment in mental health systems is required to manage the current crisis and ensure future sustainability.

Young adult mental health during the United Kingdom’s first COVID-19 lockdown: the benefit of living with parents and siblings

ABSTRACT UK young adults saw sharp mental health declines during the COVID-19 pandemic. This paper examines whether living with siblings helped moderate this negative effect. We compare the outcomes of young adults (age 19), i) who were living with parents and siblings, with ii) those who were living with only parents, and iii) with those who were living away from parents. We used data from the Millennium Cohort Study COVID-19 survey, linked with the mainstage survey (N = 2,578), and captured mental health with: the Shortened Warwick-Edinburgh Mental Well-being Scale and the Kessler-6 Psychological Distress scale. As young men and women may be differently affected by sibling co-residence, we vary living arrangements effects by gender. While average young adult mental health deteriorated during the first national lockdown, there were variations by gender and living arrangements. For young men, living with siblings was associated with improved mental health on both measures during the first COVID-19 lockdown. For young women, living with parents was associated with lower psychological distress than living away from home, but siblings provided no additional benefit. Data from later in the pandemic suggests that, as young adults became more accustomed to social restrictions, the importance of family living arrangements declined.

How intergenerational estrangement matters for maternal and adult children's health

AbstractObjectiveWe compare maternal and adult child health outcomes across (1) estranged (i.e., no contact, or low contact and low quality), (2) socially positive (i.e., high quality, moderate to high contact), and (3) socially negative (i.e., high contact but low quality) maternal–adult child relationships.BackgroundWe develop intergenerational resource, crisis, and strain theories to test the link between socially positive, socially negative, and estranged maternal–adult child dynamics and the health of both generations.MethodRegression models of National Longitudinal Survey of Youth (NLSY79 and NLSY79‐CYA) data compare self‐rated health and CES‐D scores across maternal–adult child relationship types (N = 2609 mothers; 5590 children).ResultsMothers with estranged ties report poorer health relative to those with socially positive ties. Mothers with socially negative ties report statistically similar health relative to mothers with either socially positive or estranged ties. The health of adult children with estrangement exposure is similar to those in socially negative ties, while adult children with socially negative ties have worse health relative to those in socially positive ties. Estranged adult children report worse self‐rated health than those in socially positive ties, but adult children's mental health is not statistically different than those in socially positive ties. Family‐level analyses incorporating siblings suggest that for mothers, an estranged/socially negative tie with any child is associated with worse self‐rated health; for adult children, one's own maternal relationship is more consequential than the sibling context.ConclusionThis study has implications for research and theory on the health cost of socially negative and estranged intergenerational ties.

Use of physical activity as a coping strategy mediates the association between adolescent team sports participation and emerging adult mental health

PurposeWe explored how team sport participation during adolescence may have prepared emerging adults to use physical activity (PA) as a coping strategy during the COVID-19 pandemic and therefore protect their mental health. MethodsMATCH study participants reported their involvement in team sports from age 11 to 18. At age 20, in the context of the COVID-19 pandemic, they reported their level of positive mental health, strategies to cope with stress, and perception of how helpful these are. Mediation analyses were used to estimate the natural direct effect of number of years of team sport participation during adolescence on emerging adults’ mental health, and the natural indirect effect through using PA as a coping strategy. ResultsData from 454 participants were available. PA was the most prevalent coping strategy reported (51.5%) and 74% of those using this strategy reported it helped a lot. More years of team sport participation during adolescence was associated with higher odds of reporting PA as a coping strategy (OR [95% CI] = 1.012 [1.007; 1.017]) and with higher level of mental health during emerging adulthood (β [95% CI] = 0.059 [0.024; 0.095]). The natural indirect effect suggests that the use of PA as a coping strategy partially explained the association between team sport participation in adolescence and mental health in emerging adulthood (NIE [95% CI] = 0.038 [0.002;0.074]). DiscussionMore team sports participation during adolescence is associated with better mental health during emerging adulthood. This association may operate through using PA to cope with stress.

Socioeconomic and Psychosocial Stressors Contributing to General Adult Community Mental Health Recovery Service Referrals in Epsom, Surrey, a Retrospective Case Note Analysis

Socioeconomic and Psychosocial Stressors Contributing to General Adult Community Mental Health Recovery Service Referrals in Epsom, Surrey, a Retrospective Case Note Analysis

SafeVRwards: Designing a complementary virtual reality module to the Safewards framework intended to relax and manage conflict in mental health wards

BackgroundAggression and negative activation in mental health inpatient units pose significant challenges for both patients and staff with severe physical and psychological ramifications. The Safewards model is an evidence-based conflict-containment...

A Quality Improvement Project to Investigate How Addenbrooke's Cognitive Examination-III (ACE-III) Training Improves the Accuracy of ACE-III Scoring in an Older Adult Community Mental Health Team

A Quality Improvement Project to Investigate How Addenbrooke's Cognitive Examination-III (ACE-III) Training Improves the Accuracy of ACE-III Scoring in an Older Adult Community Mental Health Team

Quality Improvement Project: Lithium Monitoring in an Older Adult Community Mental Health Team

Quality Improvement Project: Lithium Monitoring in an Older Adult Community Mental Health Team

Adverse Event Reporting in Older Adult Mental Health: A Theme Analysis

Adverse Event Reporting in Older Adult Mental Health: A Theme Analysis

Venous Thromboembolism (VTE) Risk Assessment in an Older Adult Mental Health Inpatient Ward

Venous Thromboembolism (VTE) Risk Assessment in an Older Adult Mental Health Inpatient Ward

Neuropsychological profiles in first-episodes psychosis and their relationship with clinical, metacognition and social cognition variables.

An increasing interest in the assessment of neuropsychological performance variability in people with first-episode psychosis (FEP) has emerged. However, its association with clinical and functional outcomes requires further study. Furthermore, FEP neuropsychological subgroups have not been characterized by clinical insight or metacognition and social cognition domains. The aim of this exploratory study was to identify specific groups of patients with FEP based on neuropsychological variables and to compare their sociodemographic, clinical, metacognition and social cognition profiles. A sample of 149 FEP was recruited from adult mental health services. Neuropsychological performance was assessed by a neuropsychological battery (WAIS-III; TMT; WSCT; Stroop Test; TAVEC). The assessment also included sociodemographic characteristics, clinical, functional, metacognition and social cognition variables. Two distinct neuropsychological profiles emerged: one neuropsychological impaired cluster (N = 56) and one relatively intact cluster (N = 93). Significant differences were found between both profiles in terms of sociodemographic characteristics (age and level of education) (p = 0.001), clinical symptoms (negative, positive, disorganized, excitement and anxiety) (p = 0.041-0.001), clinical insight (p = 0.038-0.017), global functioning (p = 0.014), as well as in social cognition domains (emotional processing and theory of mind) (p = 0.001; p = 0.002). No significant differences were found in metacognitive variables (cognitive insight and 'jumping to conclusions' bias). Relationship between neurocognitive impairment, social cognition and metacognition deficits are discussed. Early identifying of neuropsychological profiles in FEP, characterized by significant differences in clinical and social cognition variables, could provide insight into the prognosis and guide the implementation of tailored early-intervention.

The impact of long-term care insurance on family care for older adults: The mediating role of intergenerational financial support.

Rapid population aging has been placing heavy tolls on Chinese family caregivers. Previous empirical evidence from multiple countries have shown that establishing national long-term care insurance was effective in reducing family care burdens. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) wave 2011 to 2018, this study examined the effects of implementing the pilot long-term care insurance program on family care received by the Chinese older adults, by using a time-varying Difference-in-Differences (DID) method. The results showed that: (1) the implementation of the pilot long-term care insurance program has led to a 17.2% decline in general for family care received by the Chinese older adults. (2) The effect of participating in the pilot program on family care received differed by respondent's household registration, health status, marital status, and possesion of retirement pension, and were specifically pronounced among those who were urban residents, having spouse, living with disabilities, and living with no retirement pension. (3) Further results from the mechanism analyses showed that the pilot long-term care insurance program decreased the level of family care by reducing the dual intergenerational financial support between older adults and their adult children. (4) Although participating in the pilot program decreased older adult's dependence on their adult children, their physical and mental health status were not negatively affected. This study contributes to the existing literature by evaluating the effects of implementing the pilot long-term care insurance program on family care received by the Chinese older adults, and lends supports to the previous studies that participating in long-term care insurance significantly reduces old adults' demand for family care, but not in sacrifice of their physical and mental well-being.

Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains.

This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.

An epidemiological study of season of birth, mental health, and neuroimaging in the UK Biobank.

Environmental exposures during the perinatal period are known to have a long-term effect on adult physical and mental health. One such influential environmental exposure is the time of year of birth which affects the amount of daylight, nutrients, and viral load that an individual is exposed to within this key developmental period. Here, we investigate associations between season of birth (seasonality), four mental health traits (n = 137,588) and multi-modal neuroimaging measures (n = 33,212) within the UK Biobank. Summer births were associated with probable recurrent Major Depressive Disorder (β = 0.026, pcorr = 0.028) and greater mean cortical thickness in temporal and occipital lobes (β = 0.013 to 0.014, pcorr<0.05). Winter births were associated with greater white matter integrity globally, in the association fibers, thalamic radiations, and six individual tracts (β = -0.013 to -0.022, pcorr<0.05). Results of sensitivity analyses adjusting for birth weight were similar, with an additional association between winter birth and white matter microstructure in the forceps minor and between summer births, greater cingulate thickness and amygdala volume. Further analyses revealed associations between probable depressive phenotypes and a range of neuroimaging measures but a paucity of interactions with seasonality. Our results suggest that seasonality of birth may affect later-life brain structure and play a role in lifetime recurrent Major Depressive Disorder. Due to the small effect sizes observed, and the lack of associations with other mental health traits, further research is required to validate birth season effects in the context of different latitudes, and by co-examining genetic and epigenetic measures to reveal informative biological pathways.

Helicopter Parenting Behaviors and Emerging Adult Mental Health: The Mediating Role of Emotion Dysregulation

Helicopter parenting during emerging adulthood, a developmental period highlighting autonomy and self-reliance, can undermine college students’ well-being. The current study examined the mediating role of emotion dysregulation in the association between helicopter parenting and mental health outcomes among college-aged adults. A sample of 790 college students completed questionnaires on perceived helicopter parenting, emotion dysregulation, depression, social anxiety, and alcohol use. Results generally supported the hypothesized mediation model, but associations depended on the specific helicopter parenting behavior, emotion dysregulation dimension, and mental health outcome. Autonomy limiting was particularly detrimental to all emotion dysregulation dimensions and mental health, whereas information-seeking behaviors may be beneficial to emerging adults’ outcomes. Impulse control difficulties and lack of emotional clarity emerged as robust mediators. The findings highlight the importance of disentangling specific helicopter parenting behaviors as well as emotion dysregulation as a mechanism of risk, providing useful clinical implications for the improvement of college students’ well-being.

Perceived Parental Involvement in Childhood and Its Relationship with Adult Attachment Styles and Depression in Adults

Parental involvement is crucial as it shapes not only childhood development but also influences long-term psychological well-being and relational patterns in adulthood. This cross-sectional study delves into the intricate dynamics between parental involvement during childhood, adult attachment styles, and depression among a diverse sample of 120 adults aged 18 and above. Participants were recruited through various channels and administered the Parental Involvement Scale (PIS), Adult Attachment Scale (AAS), Beck's Depression Inventory (BDI), and a demographic form. Through rigorous data analysis, including correlation techniques, significant associations emerged, shedding light on the complex interrelationships among these variables. The findings underscore the enduring impact of parental involvement on adult attachment styles and mental health outcomes, emphasizing the importance of early familial influences in shaping individual psychological well-being. Nature of human development, informing future research endeavors and intervention strategies aimed at promoting healthy attachment patterns and mitigating depressive symptoms in adulthood are studied.

Modifiable protective factors for mental health resilience in the offspring of depressed parents: A high-risk longitudinal cohort spanning adolescence and adulthood.

Several protective factors have been identified for mental health (MH) resilience in adolescent offspring of depressed parents. However, it is unclear if these effects persist into adulthood. Depressed parents and their offspring (N=188) from the Early Prediction of Adolescent Depression study were assessed four times (mean offspring ages 12.39, 13.77, 14.82, and 23.41). Mental health resilience was examined using residual scores (better-than-expected mood-, behaviour-, or anxiety-related MH at mean age 23 given risk exposure), and categorically as sustained good MH across adolescence and young adulthood. Only 9.2% of young adults demonstrated sustained good MH. Parents of resilient individuals showed lower comorbidity (anxiety, antisocial behaviour and harmful drinking) and higher depression remission. Considering adolescent protective factors, weak evidence was observed of associations of mood-resilience with adolescent peer-relationship quality (β=-0.20, 95%CI:-0.36, -0.04); friendship quality (β=-0.14, 95%CI:-0.31, 0.02); risk adjustment (β=-0.16, 95%CI:-0.34, 0.03) and dysfunctional attitudes (β=0.18, 95%CI:0.01, 0.35). There was weak evidence of behavioural-resilience association with parent positive expressed emotion (β=-0.15, 95%CI:-0.31, 0.02) and offspring exercise (β=-0.37, 95%CI:-0.77, 0.03). No adolescent protective factors showed an association with anxiety-resilience. For sustained good MH, there was weak evidence of an association with inhibitory control (OR=0.39, 95%CI:0.14, 1.07). Strong evidence was observed for associations between young adult-reported peer relationship quality and mood-resilience (β=-0.35, 95%CI:-0.53, -0.17), behavioural-resilience (β=-0.33, 95%CI:-0.51, -0.14) and anxiety-resilience (β=-0.34, 95%CI:-0.53, -0.14), while weak evidence was observed of an association of social activities with anxiety-resilience (β=-0.51, 95%CI:-0.97, -0.06). We found limited evidence for the long-lasting effects of adolescent protective factors on adult MH resilience. Social factors remained protective into young adulthood, while family factors did not. Early preventative intervention might not be sufficient to maintain good long-term MH, and young people will likely require more prolonged support.