Changes In Mental Health Symptoms Research Articles

Randomized Feasibility Pilot of an Executive Functioning Intervention Adapted for Children's Mental Health Settings.

The critical role of executive functioning in autism as well as the co-occurring mental health challenges common among autistic youth support to the immense value of interventions targeting executive functioning for enhancing mental health services for autistic children. The goal of the present study was to conduct a randomized feasibility trial of Unstuck and On Target, an executive functioning intervention, adapted for delivery in children's community mental health setting. Mental health therapists (n = 26) enrolled with participating autistic clients (n = 32) were randomized to receive training in and deliver the adapted Unstuck intervention or to deliver care as usual. We completed masked observational measures of Unstuck strategy use (fidelity) during recorded sessions of participating therapist-client dyads and collected measures of acceptability from participating clients and their caregivers. We also collected measures of pre-post changes in executive functioning and mental health symptoms. Therapists trained in Unstuck demonstrated significantly higher use of Unstuck strategies compared to usual care therapists. Caregivers and autistic clients perceive adapted Unstuck as highly acceptability and helpful. Autistic clients whose therapists were trained in adapted Unstuck demonstrated larger pre-post changes in executive functioning compared to usual care. Across all participating clients, changes in executive functioning were significantly related to changes in mental health symptoms. Finally, clients of therapists trained in adapted Unstuck demonstrated moderate improvements in overall mental health symptoms. The current study provides preliminary evidence of the feasibility and impact of Unstuck and On Target for children's community mental health settings.

Anxiety and depressive symptoms and migraine-related outcomes in children and adolescents.

The objective of this study was to explore the longitudinal relationship between anxiety and depressive symptoms and migraine outcomes in children and adolescents. Children and adolescents with migraine experience more anxiety and depressive symptoms than their peers without migraine, but it is unknown if these symptoms are associated with differential migraine outcomes. In this prospective clinical cohort study, children and adolescents aged 8.0-18.0 years with migraine completed headache questionnaires and validated measures of anxiety and depressive symptoms (Patient-Reported Outcomes Measurement Information System) at an initial consultation and at their first follow-up visit with a neurologist. Changes in monthly headache frequency and changes in migraine-related disability (Pediatric Migraine Disability Assessment) were tracked at each time point. The relationships between these migraine outcomes and anxiety and depressive symptoms were estimated using models controlling for sex, age, headache frequency, and treatment type. There were 123 consenting participants. In models adjusted for age, sex, baseline disability score, and treatment type, baseline anxiety and depressive symptom levels were not significantly associated with change in headache frequency (for anxiety symptoms: β = -0.05, 95% confidence interval [CI] = -0.268 to 0.166, p = 0.639; for depressive symptoms: β = 0.14, 95% CI = -0.079 to 0.359, p = 0.209). Similarly, in models adjusted for age, sex, baseline headache frequency, and treatment type, the change in disability was not associated with baseline anxiety (β = -0.45, 95% CI = -1.69 to 0.78, p = 0.470), nor with baseline depressive symptom scores (β = 0.16, 95% CI = -1.07 to 1.40, p = 0.796). In post hoc exploratory analyses (N = 84 with anxiety and N = 82 with depressive symptom data at both visits), there were also no significant associations between change in mental health symptoms and change in headache frequency (for anxiety symptoms: β = -0.084, 95% CI = -0.246 to 0.078, p = 0.306; for depressive symptoms: β = -0.013, 95% CI = -0.164 to 0.138, p = 0.865). Similarly, the change in disability scores between visits was not related to the change in anxiety (β = 0.85, 95% CI = -0.095 to 1.78, p = 0.077) nor depressive symptom scores (β = 0.32, 95% CI = -0.51 to 1.15, p = 0.446). Baseline anxiety and depressive symptom levels were not associated with longitudinal migraine outcomes and neither were longitudinal changes in anxiety and depressive symptom levels; this contradicts popular clinical belief that mental health symptoms predict or consistently change in tandem with migraine outcomes.

Evolving policies, enduring impacts: Cross-sectional surveys of mental health, risk-related perceptions, and coping behaviors throughout China's U-turn in its stringent zero-COVID policy.

China's early encounter with COVID-19 and protracted prevention policies, presents an ideal case to study psychological changes during a prolonged and evolving crisis. This study aims to examine the shifts in mental health symptoms, risk-related perceptions, and associated coping behaviors within two large-scale samples of Chinese respondents, spanning from the pandemic's onset to the relaxation of the zero-COVID policy. Moreover, the study strives to identify protective factors that could potentially mitigate the pandemic's impact. Two online surveys were conducted during China's initial pandemic phase (February 25-28, 2020) and the relaxation of the zero-COVID policy (March 30-April 18, 2023). Participants' mental health indicators, risk-related perceptions, and coping behaviors were assessed using the Depression, Anxiety, and Stress Scale-21 Items, the 9-item Bergen Burnout Inventory, and other adopted scales. Multivariable linear models were employed to examine the enduring psychological impact of the pandemic and identify potential protective factors. Analysis of two datasets comprising 1946 and 1878 participants from the onset and the remission of China's COVID-19 pandemic revealed an upward trend in various mental health indicators of Chinese respondents between 2020 and 2023. Similarly, risk-related perceptions, encompassing perceived severity, susceptibility, and self-efficacy, and risk-related information sharing witnessed an increase. Being female, single, residing in rural areas, having higher education, and lacking acquaintances with COVID-19 are protective factors against mental health risks. Additionally, being female, married, over 30, living in big cities, having higher education, and lacking personal or acquaintances' infection history are associated with engaging in protective behaviors and reduced information avoidance. The study investigated the changes in mental health symptoms, risk-related perceptions, and coping behaviors of Chinese respondents between 2020 and 2023 and identified protective factors against the pandemic's impact, including demographic (gender, age), social (education, marital status, residence), and exposure (infection history) elements. Understanding these fluctuations and protective elements is crucial for policymakers, as it can inform the development of targeted strategies to alleviate negative psychological impacts while effectively managing future pandemics.

Collegiate student-athlete mental health symptom trajectories across a competitive season: do training load and resilience matter?

ABSTRACT Student-athlete mental health is an important and complex issue necessitating examination of variables that may explain changes in key outcomes during training and competition periods. Further, in-season changes in mental health may be predicted by student-athlete training load or psychological resilience and should be examined further. This longitudinal study assessed changes in mental health symptoms of depression, anxiety, and subjective well-being across a competitive season and examined potential interactive effects of resilience and training load in predicting mental health symptoms over time. Participants were 160 NCAA Division I student-athletes between 18–23 years old (mean age = 19.9 ± 1.3). We measured mental health symptoms and resilience at 3 timepoints (across 12 weeks) throughout a competitive season with psychometric questionnaires. Daily training loads were also collected and then used to calculate average acute to chronic workload ratios (ACWR). Positive mental health symptoms did not change across student-athletes; whereas, negative symptoms changed over time with the highest levels of symptoms occurring in the middle of the season. Resilience was positively associated with subjective well-being and negatively associated with anxiety and depression across the study period. ACWR was not associated with depression or anxiety symptom scores but a significant interaction between ACWR and resilience was found for subjective well-being symptoms. Specifically, resilience buffered against ACWR’s negative effect on positive mental health. Results suggest the importance of student-athlete resilience during the competition season and evaluation of depression and anxiety at pre-season with mid-season re-evaluation.

Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey.

Children and youth experienced marked impacts on day-to-day life in the COVID-19 pandemic that were associated with poorer familial and friend relationships, and greater mental health challenges. Few studies provide self-report data on mental health symptoms from children and youth themselves. We sought to examine the associations between social factors and child and youth self-reported symptoms of worsened mood, anxiety, and irritability during the COVID-19 pandemic. A nationally representative cross-sectional survey was administered online to collect self-report data across 10 Canadian provinces among children (11-14years) and youth (15-18years), April-May 2022. Age-appropriate questions were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. Associations between a priori defined social factors (e.g., relationship quality) and respondent self-reported mental health were evaluated using ordinal logistic regression models adjusted for age, sex, and geographic location. We analyzed data from 483 (51.7%) children (11-14years; 227, 47.0% girls) and 450 (48.3%) youth (15-18years; 204, 45.3% girls). The parents of most children and youth had resided in Canada for over 20years (678, 72.7%). Over one-quarter of children and youth self-identified as Black, Indigenous, or a Person of Color (134, 27.7%; 134, 29.8%, respectively). Over one-third of children and youth self-reported symptoms of worsened mood (149, 30.9%; 125, 27.8%, respectively), anxiety (181, 37.5%; 167, 37.1%, respectively), or irritability (160, 33.1%; 160, 35.6%, respectively) during, compared to pre-pandemic. In descending order of odds ratios (OR), for children and youth, worsened familial relationships (during compared to pre-pandemic) was associated with the self-reported symptoms of worsened mood (child: OR 4.22, 95%CI 2.51-6.88; youth: OR 6.65 95%CI 3.98-11.23), anxiety (child: OR 4.24, 95%CI2.69-6.75; youth: OR 5.28, 95%CI 3.17-8.86), and irritability (child: OR 2.83, 95%CI 1.76-4.56; youth: OR 6.46, 95%CI 3.88-10.90). Self-reported data from a nationally representative sample of children and youth suggest strong associations between social factors and mental health during the COVID-19 pandemic. Interventions targeting child and youth familial relationships may positively impact child and youth mental health.

Schizophrenia in Autistic People with Intellectual Disabilities. Treatment and Interventions.

Autistic people with intellectual disabilities appear to be at increased risk of schizophrenia. While current recommendations emphasize adapting interventions used for people with schizophrenia in general, few studies to date have investigated treatment of co-occurring schizophrenia in this specific population. To explore what interventions are provided to autistic people with intellectual disabilities and co-occurring schizophrenia in specialized mental health services, and to investigate whether changes in mental health symptoms and challenging behavior occurred during treatment. Using data from a longitudinal, national multicenter study, interventions provided to 26 autistic individuals with intellectual disabilities and co-occurring schizophrenia were explored. Symptoms were measured using the Psychopathology in Autism Checklist (PAC) and the Aberrant Behavior Checklist ABC) at referral (T1), at the end of treatment (T2), and at follow-up 12 months after T2 (T3). A broad range of interventions were provided to the participants, including inpatient admission, psychopharmacological treatment, various psychosocial interventions, and supportive interventions. Scores on the PAC and ABC were significantly lower at T2 than T1 for most scales, and no significant change was found from T2 to T3.Treatment of co-occurring schizophrenia appears feasible and effective in autistic people with intellectual disabilities.

Longitudinal study of peer victimization, social support, and mental health during early adolescence.

Peer victimization predicts the development of mental health symptoms in the transition to adolescence, but it is unclear whether and how parents and school environments can buffer this link. We analyzed two-year longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study, involving a diverse sample of 11 844 children across the United States (average at baseline = 9.91 years; standard deviation = 0.63; range = 8.92-11.08; complete case sample = 8385). Longitudinal associations between peer victimization and two-year changes in mental health symptoms of major depression disorder (MDD), separation anxiety (SA), prodromal psychosis (PP), and attention-deficit/hyperactivity disorder (ADHD) were examined including a wide range of covariates. Mixed linear models were used to test for the moderating effects of parental warmth and prosocial school environment. 20% of children experienced peer victimization. Higher exposure to peer victimization was associated with increases in MDD, SA, and ADHD symptoms. Parental warmth was associated with decreases in MDD symptoms but did not robustly buffer the link between peer victimization and mental health symptoms. Prosocial school environment predicted decreases in PP symptoms and buffered the link between peer victimization and MDD symptoms but amplified the link between peer victimization and SA and ADHD symptoms. Peer victimization is associated with increases in mental health symptoms during the transition to adolescence. Parental warmth and prosocial school environments might not be enough to counter the negative consequences of peer victimization on all mental health outcomes.

The "Young Athlete Body Project"-A pilot study evaluating the acceptability of and results from an eating disorder prevention program for adolescent athletes.

The high frequency of eating disorders (EDs) in sports speaks of a need for early-stage preventive measures. This study evaluated the acceptability of an age, sex, and sports adapted version of the "Body Project" and changes in mental health symptoms. This noncontrolled pilot study included a class of athletes from 18 sports (N = 73, 13-14 years) at a sport-specialized junior high school in six small-group workshops. We interviewed 34 athletes on program acceptability, and all athletes responded to questionnaires at pretest, posttest, and 6-month follow-up including the Body Appreciation Scale 2-Children, Social Attitudes towards Appearance Questionnaire-4 revised, Eating Disorder Examination Questionnaire Short form-12 modified, and questions about body appearance pressure (BAP). Athletes found the program acceptable and beneficial, but some missed physically oriented activities or did not identify with the focus, particularly boys. There were acceptable levels in mental health constructs before the workshops. There were temporary changes in the percentage of boys experiencing "BAP in society" by -14.8% points (95% CI: -.6 to .0, p = .04), % in total group experiencing "BAP at school" by +11% points (95% CI: .0-.2, p = .05), thinness idealization by girls (g = .6, p = .002) and total group (g = .4, p = .006), and muscularity idealization by boys (g = .3, p = .05) and total group (g = .23, p = .04). Athletes experienced benefits from the Young Athlete Body Project. Seeing stabilization in outcomes may mean a dampening of the otherwise expected worsening in body appreciation and ED symptoms over time. Adolescent athletes are at risk for developing EDs. Due to lack of prevention programs for this group, we adapted and evaluated a well-documented effective program, the Body Project, to fit male and female athletes <15 years. The athletes accepted the program and experienced participation benefits, with stronger acceptance among girls. Our promising findings encourage larger scaled randomized controlled trials to further evaluate a refined version this program among very young athletes.

Perceptions of mental health providers of the barriers and facilitators of using and engaging youth in digital mental-health-enabled measurement based care.

Increased rates of mental health disorders and substance use among youth and young adults have increased globally, furthering the strain on an already burdened mental health system. Digital solutions have been proposed as a potential option for the provision of timely mental health services for youth, with little research exploring mental health professional views about using such innovative tools. In Alberta, Canada, we are evaluating the implementation and integration of a digital mental health (dMH) platform into existing service pathways. Within this paper we seek to explore mental health professionals' perceptions of the barriers and facilitators that may influence their utilization of digital MH-enabled measurement-based care (MBC) with the youth who access their services. A qualitative, descriptive methodology was used to inductively generate themes from focus groups conducted with mental health professionals from specialized mental health services and primary care networks in Alberta. As mental health professionals considered the barriers and facilitators of using dMH with youth, they referenced individual and family barriers and facilitators to consider. Providers highlighted perceived barriers, including: first, cultural stigma, family apprehension about mental health care, and parental access to dMH and MBC as deterrents to providers adopting digital platforms in routine care; second, perceptions of increased responsibility and liability for youth in crisis; third, perception that some psychiatric and neurodevelopmental disorders in youth are not amenable to dMH; fourth, professionals contemplated youth readiness to engage with dMH-enabled MBC. Participants also highlighted pertinent facilitators to dMH use, noting: first, the suitability of dMH for youth with mild mental health concerns; second, youth motivated to report their changes in mental health symptoms; and lastly, youth proficiency and preference for dMH options. By identifying professionals' perceptions of barriers and facilitators for youth users, we may better understand how to address misconceptions about who is eligible and appropriate for dMH through training and education.

Dyadic patterns of mental health and quality of life change in partners and patients during three months of cardiac rehabilitation.

The effects of mental health on quality of life (QoL) over the course of a couple's recovery from a patient's cardiac event are unknown as partner outcomes are rarely considered within cardiac rehabilitation. To capture the transactional nature of recovery from a cardiac event, this research investigated the link between longitudinal changes in the mental health of couples in which at least one of the partners had cardiac disease and changes in their QoL during cardiac rehabilitation. Participants (N = 184 dyads) completed questionnaires measuring anxiety, depression, and QoL at baseline (enrollment) and 3 months (discharge). Dyadic data were analyzed using the Actor-Partner Interdependence Model with integrated latent change scores. The results indicated that improved anxiety was associated with significant positive changes in physical and emotional QoL for both the patient and partner (actor effects). A reduction in depression in both partners from baseline to follow-up predicted an increase in emotional QoL for patients and partners, and an increase in physical QoL for partners (actor effects). Patients whose depression decreased from enrollment to the completion of cardiac rehabilitation were associated with partners' greater positive changes in emotional QoL than were patients whose depression did not decrease, and reductions in partners' anxiety over time predicted positive changes in patients' physical QoL (partner effects). Findings underscore the need to screen for and attend to patients' and partners' mental health outcomes postcardiac event, as positive changes in mental health symptoms may optimize changes in patients' and partners' emotional and physical QoL. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-compassion and avoidant coping as mediators of the relationship between childhood maltreatment and mental health and alcohol use in young adulthood

BackgroundExposure to childhood maltreatment increases the risk of mental health and substance use problems. Understanding the mechanisms linking maltreatment to these problems is critical for prevention. ObjectiveTo examine whether self-compassion and avoidant coping mediate the relationship between childhood maltreatment and mental ill-health and alcohol use. Participants and settingAustralians aged 18–20 years at baseline were recruited through social media and professional networks. MethodsParticipants (n = 568) completed an online survey, and were followed up annually for two subsequent surveys. Mediation models were conducted with the SPSS PROCESS macro. Maltreatment was the predictor; Wave 2 self-compassion and avoidant coping as mediators; Wave 3 mental health and alcohol use as outcomes. ResultsChildhood maltreatment predicted greater mental health symptoms (b = 0.253, 95 % CI = 0.128–0.378), and alcohol use (b = 0.057, 95 % CI = 0.008–0.107). Both self-compassion (b = 0.056, 95 % CI = 0.019–0.093) and avoidant coping (b = 0.103, 95 % CI = 0.024–0.181) mediated the relationship between maltreatment and mental health. Additionally, avoidant coping, but not self-compassion, mediated the relationship (b = 0.040, 95 % CI 0.020–0.061) with alcohol use. However, when controlling for pre-existing mental health and substance use, neither self-compassion nor avoidant coping mediated the relationship with mental health. Only avoidant coping mediated the link with alcohol use (b = 0.010, 95 % CI = 0.001–0.020). ConclusionsFindings suggests that by adulthood, self-compassion and avoidant coping may not explain future change in mental health symptoms; however, avoidant coping accounts for change in alcohol use across early adulthood. Reducing avoidant coping may prevent hazardous alcohol use across young adulthood among people exposed to childhood maltreatment.

Difficulties Among High School Students in Hanoi During the COVID-19 Lockdown Period

Objective: This study was conducted to describe the social, mental health difficulties and psychological behavior of students at some middle and high schools in Hanoi during the COVID-19 lockdown period. Methods: This is a cross-sectional study conducted in November 2021 using the form of an online survey on 5,315 students aged 11-17 years old residing in Hanoi. The four main outcome variables included family care and pressure, self-esteem, coping with stressful situations, and anxiety. Results: Results show that during the COVID-19 epidemic, about 11.6% of students experienced domestic family violence. Up to 43.5% of students assessed that they spent so much time using electronic devices that they did not have time to connect with their families. About 7.4% of students had severe anxiety symptoms, and 67.9% had mild or moderate symptoms. The participants also reported low coping skills and self-esteem during COVID social distancing. Conclusions: The COVID-19 pandemic, following school closures and distance learning, negatively impacted the psychological development of middle and high school students in Hanoi city. High schools should prioritize integrating coping strategies into their curricula and implement coping interventions to counter the harmful impact of stress on mental health. Future research should investigate the potential association between the duration of school closures and temporal changes in mental health symptoms. Key words: Economic, Social, Mental Health, COVID-19 lockdown period, High School

Changes in mental health symptoms and sociocultural factors across the COVID-19 pandemic in mothers of Mexican descent.

Latinos have been disproportionately affected by the COVID-19 pandemic in the US. Little is known about the lasting effects on mental health, particularly among mothers of young children, who historically report high levels of depression and anxiety. We examined if anxiety and depression symptoms worsened for mothers of Mexican descent across the pandemic and identified the role of sociocultural risk and protective factors on these changes. Mothers of Mexican descent (n = 141) with young children (ages 0-7) were administered surveys on mental health symptoms (anxiety and depression), stress-related sociocultural factors (perceived discrimination) before (pre-pandemic), within 3 months (early pandemic), and 18 months after the COVID-19 stay-at-home order (late pandemic). Another sociocultural factor, acculturative stress, was only measured pre-pandemic while during the later phase of the pandemic mothers reported their levels of loneliness, optimism, and coping styles. Repeated measures (RM) ANOVA demonstrated that depressive and anxiety symptoms as well as perceived discrimination increased from pre to early months of the COVID-19 pandemic and slightly lowered in late-COVID but did not return to pre-COVID levels. Two-way RM ANOVA showed that acculturative stress and perceived discrimination predicted worse mental health trajectories across the pandemic while moderations revealed that optimism buffered against, and avoidant coping increased the adverse effects of sociocultural factors on mental health. The effects of the COVID pandemic on mental health are lingering in mothers of young children; however, optimism may be a protective factor. The results also highlight the damaging effects of external factors, such as discrimination, on maternal mental health during times of crisis.

Spreading pride in all who served: A health education program to improve access and mental health outcomes for sexual and gender minority veterans.

Access to effective, replicable services is critical to reduce known mental health disparities for sexual and gender minority or LGBTQ+ veterans (lesbian, gay, bisexual, transgender, queer, questioning, and related identities). This paper examines the impact of a manualized 10-week health education group, called PRIDE in All Who Served on veteran patient experience, protective factors (e.g., identity acceptance), and mental health outcomes (e.g., suicide risk) at 10 Department of Veterans Affairs (VA) facilities. Implementation facilitation strategies (e.g., consultation, staff training) supported adoption at new sites and initial facilitators and barriers are described. Forty-four veterans (M = 47.21 years old) completed outcome surveys before and after the group. Significant improvement in acceptance concerns, identity uncertainty, community involvement, and likelihood of future suicide attempts were observed; other changes in mental health symptoms were not replicated in this sample (e.g., depression, anxiety). Open-ended veteran feedback reflected improved social support and engagement and increased self-understanding as the most frequent themes. At the facility level, Healthcare Equality Index scores (a Human Rights Campaign measure of affirmative care climate) improved from 30% to 90% achieving top-performer/leader status from pre- to postimplementation. Manualized approaches, like PRIDE in All Who Served, that are based on established minority stress models and can be spread for use with diverse LGBTQ+ veterans (e.g., age, race, gender identity, sexual orientation, rurality, housing) are needed. The PRIDE in All Who Served program is an increasingly available resource to VA clinicians advocating for greater health equity within a national healthcare setting. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Brief, modular, transdiagnostic, cognitive-behavioral intervention for anxiety in veteran primary care: Development, provider feedback, and open trial.

Anxiety is undertreated in primary care, and most treatment provided is pharmacological rather than behavioral. Integrating behavioral health providers (BHPs) using the Primary Care Behavioral Health (PCBH) model can help address this treatment gap, but brief interventions suitable for use in PCBH practice are needed. We developed a modular, cognitive-behavioral anxiety intervention, Modular Anxiety Skills Training (MAST), that is evidence-based, transdiagnostic, feasible for PCBH, and patient-centered. MAST comprises up to six 30-min sessions emphasizing skills training. This article describes the rationale for and development of MAST as well as pilot work in the Veterans Health Administration (VA) to tailor and refine MAST for delivery to Veterans in VA primary care (MAST-V) to improve feasibility for VA BHPs and acceptability to Veterans. We used a convergent mixed-methods design with concurrent data collection. In phase one, we interviewed five BHPs to obtain feedback on the treatment manual. BHPs assessed MAST-V to be highly compatible with PCBH and provided suggestions to enhance feasibility. In phase two, we conducted an open trial in which six Veterans experiencing clinically significant anxiety received and provided feedback on all nine possible modules; we also assessed changes in mental health symptoms and functioning as well as treatment satisfaction and credibility. Veterans found MAST-V to be highly acceptable, and pre-post clinical outcomes were very promising with large effect sizes. Findings from this initial pilot provide preliminary support for the feasibility, acceptability, and efficacy of MAST-V and suggest further research with a randomized clinical trial is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A systematic review of the impact of the COVID-19 pandemic on the mental health of adolescents and young people with disabilities aged 15–29 years

BackgroundThe COVID-19 pandemic has exacerbated the psychological burden on young people around the world and may have disproportionately large impacts for young people with disabilities. This review aims to systematically review the quantitative evidence on the impact of the COVID-19 pandemic on the mental health of young people with disabilities and evaluate the quality of included studies.MethodsA systematic search was conducted using 5 electronic databases. The quality of the studies was assessed using the SIGN risk of bias assessment tool. A narrative synthesis was performed to synthesize the results of included studies.ResultsThe initial search yielded 1935 studies, of which two met the eligibility criteria, one longitudinal study and one cross-sectional study, both assessed to be of low quality. In the cross-sectional study, young people with intellectual and developmental disabilities self-reported an increase in mental health symptoms. The longitudinal study found no evidence of a change in mental health symptoms from pre-pandemic to during the pandemic among young people with autism spectrum disorder, although these individuals reported negative impacts of the COVID-19 pandemic on their emotional or mental health.ConclusionsThe findings of this review provide some weak evidence of a negative impact of the COVID-19 pandemic on the mental health of young people with disabilities. Importantly, the findings highlight the lack of research in this area. More research is needed to investigate the impact of the pandemic on the mental health of young disabled people, in order for governments to develop emergency preparedness plans to safeguard the well-being of this population.

The impact of psychological strengths on Veteran populations' mental health trajectories during the COVID-19 pandemic.

Mental health trajectories during the COVID-19 pandemic have been examined in Veterans with tenuous social connections, i.e., those with recent homelessness (RHV) or a psychotic disorder (PSY), and in control Veterans (CTL). We test potential moderating effects on these trajectories by psychological factors that may help individuals weather the socio-emotional challenges associated with the pandemic (i.e., 'psychological strengths'). We assessed 81 PSY, 76 RHV, and 74 CTL over 5 periods between 05/2020 and 07/2021. Mental health outcomes (i.e., symptoms of depression, anxiety, contamination concerns, loneliness) were assessed at each period, and psychological strengths (i.e., a composite score based on tolerance of uncertainty, performance beliefs, coping style, resilience, perceived stress) were assessed at the initial assessment. Generalized models tested fixed and time-varying effects of a composite psychological strengths score on clinical trajectories across samples and within each group. Psychological strengths had a significant effect on trajectories for each outcome (ps < 0.05), serving to ameliorate changes in mental health symptoms. The timing of this effect varied across outcomes, with early effects for depression and anxiety, later effects for loneliness, and sustained effects for contamination concerns. A significant time-varying effect of psychological strengths on depressive symptoms was evident in RHV and CTL, anxious symptoms in RHV, contamination concerns in PSY and CTL, and loneliness in CTL (ps < 0.05). Across vulnerable and non-vulnerable Veterans, presence of psychological strengths buffered against exacerbations in clinical symptoms. The timing of the effect varied across outcomes and by group.

Association of systemic inflammation with posttraumatic stress disorder after a myocardial infarction

BackgroundAdverse mental health conditions including depression, posttraumatic stress disorder (PTSD), and anxiety are prevalent among patients who survive myocardial infarctions (MI) and are associated with adverse outcomes. The mechanisms underlying these associations, however, are not well understood. Inflammatory pathways may mediate the cardiovascular outcomes of patients with mental health disorders. We examined the bidirectional association between PTSD symptoms and inflammatory biomarkers in a young/middle-aged post MI population. We further examined how this association may differ between women and men as well as between Black and non-Black individuals. MethodsParticipants included individuals with early onset MI between the ages 25 and 60. Mental health scores for depression, PTSD, perceived stress, and anxiety as well as inflammatory biomarkers, interleukin-6 (IL-6) and high sensitivity C-reactive protein (hsCRP), were collected at baseline and at six-month follow up. We examined the bidirectional changes in mental health symptoms and inflammatory biomarkers between baseline and follow-up. ResultsAmong 244 patients in the study (mean age: 50.8, 48.4% female, 64.3% Black), the geometric means for IL-6 level and hsCRP at rest were 1.7 pg/mL and 2.76 mg/L, respectively. Mental health scores at baseline did not consistently predict changes in inflammatory biomarkers at follow-up. However, baseline levels of both IL-6 and hsCRP were robustly associated with an increase in re-experiencing PTSD symptoms at 6 months: in adjusted linear mixed models, there was a 1.58-point increase in re-experiencing PTSD symptoms per unit of baseline hsCRP (p = 0.01) and 2.59-point increase per unit of baseline IL-6 (p = 0.02). Once the analysis was stratified by race, the association was only noted in Black individuals. Baseline inflammation was not associated with change in any of the other mental health symptom scores. ConclusionMarkers of inflammation are associated with an increase in post-event PTSD symptoms in younger or middle-aged patients who experienced an MI, especially Black patients. These results suggest a mechanistic link between inflammation and the development of PTSD among individuals with cardiovascular disease.

Evaluating the Impact of Mask Mandates and Political Party Affiliation on Mental Health Internet Search Behavior in the United States During the COVID-19 Pandemic: Generalized Additive Mixed Model Framework.

The impacts of the COVID-19 pandemic on mental health worldwide and in the United States have been well documented. However, there is limited research examining the long-term effects of the pandemic on mental health, particularly in relation to pervasive policies such as statewide mask mandates and political party affiliation. The goal of this study was to examine whether statewide mask mandates and political party affiliations yielded differential changes in mental health symptoms across the United States by leveraging state-specific internet search query data. This study leveraged Google search queries from March 24, 2020, to March 29, 2021, in each of the 50 states in the United States. Of the 50 states, 39 implemented statewide mask mandates-with 16 of these states being Republican-to combat the spread of COVID-19. This study investigated whether mask mandates were associated differentially with mental health in states with and without mandates by exploring variations in mental health search queries across the United States. In addition, political party affiliation was examined as a potential covariate to determine whether mask mandates had differential associations with mental health in Republican and Democratic states. Generalized additive mixed models were implemented to model associations among mask mandates, political party affiliation, and mental health search volume for up to 7 months following the implementation of a mask mandate. The results of generalized additive mixed models revealed that search volume for "restless" significantly increased following a mask mandate across all states, whereas the search volume for "irritable" and "anxiety" increased and decreased, respectively, following a mandate for Republican states in comparison with Democratic states. Most mental health search terms did not exhibit significant changes in search volume in relation to mask mandate implementation. These findings suggest that mask mandates were associated nonlinearly with significant changes in mental health search behavior, with the most notable associations occurring in anxiety-related search terms. Therefore, policy makers should consider monitoring and providing additional support for these mental health symptoms following the implementation of public health-related mandates such as mask mandates. Nevertheless, these results do not provide evidence for an overwhelming impact of mask mandates on population-level mental health in the United States.

Changes in mental health symptoms from April (COVID-19 outbreak) to December 2020 in Norway: A two-wave study

The main objective of the study was to investigate changes in mental health symptoms from the start of the pandemic in Norway (April) to December 2020. A total of 6017 participants completed an assessment of the survey at both time points. Main Outcome Measures: Symptoms of anxiety and depression were measured at both time points. Demographic variables and potential risk factors were assessed. There were significant changes (slight increase) in anxiety and depression, but effect sizes were small. Increases in symptoms in anxiety and depression occurred more in the general population than for people with pre-existing mental health problems. Baseline level of symptoms was the most important risk factor. Other significant risk factors included female sex, students, pre-existing mental health problems, increased tobacco use, lost job, and lacking government trust. The longitudinal results replicated findings from the first phase of the pandemic, suggesting that the number of risk factors experienced is associated with symptom severity. The results suggest that mental health symptoms have been quite stable from April to December but with a slight increase among people presenting with subclinical symptoms in April. The study obtained ethical approval from the Regional Committee for Medical and Health Research (REK Nord, 123,324).