Greater Mental Health Problems Research Articles

Challenging the use of the overall adverse childhood experiences (ACEs) score: Comparing total ACEs, maltreatment, and household dysfunction on mental health problems among White, African American, and Native American women under correctional control.

Adverse childhood experiences (ACEs) have been consistently linked to mental health problems. There have been recent conceptual and empirical critiques that suggest maltreatment and household dysfunction to not be combined to create a composite ACE score. Women in correctional custody demonstrate disproportionately high ACE levels and greater mental health problems as to racial minorities. The present study compared the effects of varying operationalizations of the ACEs measure on women's mental health stratified across race using a sample of White, African American, and Native American women in correctional custody in Oklahoma. The cross-sectional study administered a paper-and-pencil survey to 494 women. Structural equation modeling was used to test hypotheses. Maltreatment was a significant predictor of women's mental health across all racial groups but demonstrated the strongest effect among African American inmates. Household dysfunction was not a significant predictor of mental health for any racial group. When comparing the maltreatment-only model to the maltreatment and household dysfunction model, and the overall ACE score model, there was little explained variance lost. These findings indicate that maltreatment demonstrates unique associations with women's mental health and may be the driving force behind the relationship between ACEs and adult mental health among women within correctional custody. Researchers are advised to not use the overall ACE score and instead break down the measure into the maltreatment and household dysfunction subscales. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A-46 High School Soccer and Risk for Mental Health Outcomes in Adulthood: A National Longitudinal Study

Abstract Purpose: There is concern that participation in contact sports during youth might confer risk for later in life mental health problems. We examined whether playing high school soccer was associated with higher rates of depression, anxiety, and suicidality in early to middle adulthood. Methods: The National Longitudinal Study of Adolescent to Adult Health (“Add Health”) database was analyzed at Wave I (n = 6503; median age = 15), Wave III (median age = 22), Wave IV (median age = 29), and Wave V (n = 4196; median age = 38). We compared those who played soccer to those who did not play contact sports on mental health outcomes. Results: There were 221 participants who played high school soccer (102 men and 119 women) compared to 2388 who denied participation in contact sports (784 men and 1604 women). During their late 30s, approximately 17.4% of men and 31.0% of women reported a lifetime history of depression, and 15.6% of men and 28.8% of women reported a lifetime history of anxiety. Suicidal ideation, in the past year, was reported by 7.1% of men and 6.8% of women. When comparing those who played soccer to those who did not, there were no statistically significant differences in the proportions who had a lifetime diagnosis of depression or anxiety, or suicidal ideation in the past year, during Waves III, IV, or V of data collection (p-values>0.05). Conclusions: Adults who played high school soccer did not have greater mental health problems at three different time points spanning more than 20 years after high school.

Psychometric evaluation of the Russian version of the Gaming Disorder Scale for Adolescents.

Problematic gaming has become an emerging global health issue. Formal recognition of gaming disorder in the ICD-11 is a new opportunity for the discipline to conduct further investigation concerning the psychological consequences of problematic gaming. The present study investigated the psychometric properties and construct structure of the recently developed Gaming Disorder for Scale for Adolescents (GADIS-A), a multi-dimensional instrument that screens for gaming disorder symptoms, among Russian adolescent gamers. The sample comprised 933 adolescent gamers (547 boys and 386 girls) recruited via a web-based platform, using a multistage sampling method. Analysis showed the GADIS-A had very good internal consistency (Cronbach’s alpha coefficient = .891; Composite reliability = .89) and adequate test–retest reliability after two weeks (intraclass coefficient =0.68 with 95% CI [0.61, 0.77]. Exploratory structural equation modeling (ESEM) showed the data fitted well. Measurement invariance testing indicated the GADIS-A was invariant by gender and gaming medium (online vs. offline). As for criterion-related validity, high scores on the GADIS-A positively correlated with scales assessing depression, anxiety, impulsivity, and difficulties in emotion regulation, and negatively correlated with social connectedness and life satisfaction. Using latent profile analysis, four groups of gamers were identified, and problematic gaming was associated with greater mental health problems. The findings indicated that psychological comorbidity (e.g., depression and anxiety) was more prevalent among gamers with higher risk of GD. The findings indicate that GADIS-A is a reliable and valid instrument to assess the symptoms and severity of gaming disorder among Russian adolescents.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12144-021-02575-w.

The Moderating Roles of Empathy and Attachment on the Association Between Latent Class Typologies of Bullying Involvement and Depressive and Anxiety Symptoms in Singapore

Bullying involvement tends to bring about greater mental health problems among school-aged youths, and research suggests that empathy and attachment may play crucial roles in mitigating these adverse consequences. However, little is known about how different types of bullying involvement continue to contribute to mental health in higher education. This study fills the knowledge gap by examining how empathy and attachment moderate the relationship between the patterns of bullying involvement and depressive and anxiety symptoms among Singaporean university students. A total of 835 students (aged 21–24) from a public university completed an online survey. Using latent class analysis, a four-class typology was uncovered, consisting of high/multiple bully–victims, cyberbully–victims, relational and verbal victims, and persons uninvolved in bullying involvement. Multiple regression analyses showed that high/multiple bully–victims, cyberbully–victims, and relational and verbal victims tended to experience elevated depressive or anxiety symptoms compared to those who were uninvolved. Two 2-way interactions involving empathy and attachment were found: Compared to the uninvolved, being high/multiple bully–victims and having low empathy were associated with greater anxiety symptoms, and being cyberbully–victims with poor peer attachment was linked to greater anxiety symptoms. These differences in anxiety between the uninvolved and high/multiple and cyberbully–victims were non-significant at medium and high levels of empathy and at high levels of peer attachment, respectively. In order to improve the mental health of school-aged youths, practitioners should employ not only specific bullying prevention–intervention programs but also empathy- and peer-based programs.

Expert consensus on management of analgesia and sedation for patients with severe coronavirus disease 2019.

The coronavirus disease 2019 (COVID-19) has been declared a global pandemic and is a major public health issue worldwide. COVID-19 is a systemic disease damaging multiple organs, including the lung as the main target organ. Approximately 14% COVID-19 patients develop a severe disease and 5% require admission to ICU. Those critically ill patients are often in a state of stress, pain, and anxiety due to the pathophysiology of the acute stage of the disease, underlying illness, psychological factors, and environmental factors. COVID-19 increases organ function load, resulting in increased tissue oxygen consumption and respiratory dysfunction, which further damage organs and can even be life-threatening. In addition, various medical procedures including mechanical ventilation, arterial puncture, central venous catheterization, and hemodialysis could aggravate discomfort, anxiety, and pain. Meanwhile, some patients with COVID-19 have greater mental health problems and sleep disorders, which not only cause emotional fluctuations and delirium but also delay tissue repair and suppress immune function. Thus, it is necessary to assess pain, anxiety, mental health problems and sleep quality of the patients with COVID-19. At present, there are no specific antiviral drugs or vaccines against COVID-19. The use of analgesic and sedation agents is appropriate as an initial strategy in critically ill and mechanically ventilated patients with COVID-19, as it can not only relieve the discomfort of intubation and reduce ventilator-associated lung injury but also reduce sympathetic stress and protect against organ damage. No specific data exist on the optimal use of analgesics, sedatives, and agents to control delirium in patients with COVID-19. Our consensuses are mainly aimed at standardizing the management of pain, agitation, and delirium, formulating the appropriate medication plan, and achieving the optimal clinical status for severe patients with COVID-19. The statements were drawn up by a group of 15 front-line intensive care experts who fought the COVID-19 epidemic in China. The expert group defined clinical questions according to the Population, Intervention, Control, and Outcome format. A literature search was performed via PubMed and the Cochrane Library databases. The quality of evidence was assessed using the methodology described in Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). Because of the sudden outbreak of COVID-19, the proposed question could be the subject of a recommendation as an expert opinion due to non-existent or insufficient literature. A total of four rounds of expert seminars and discussions were organized to provide trustworthy recommendations. Totally experts draw up 30 statements on the management of analgesia and sedation for severe COVID-19 patients [Table 1 ]. Of these consensuses, 3 had a high level of evidence (GRADE 1±), 13 had a low level of evidence (GRADE 2±), and 14 were expert opinions. A strong agreement was reached for all statements after two rounds of scoring [Supplementary Material Manuscript-gls.pdf, https://links.lww.com/CM9/A282].Table 1: The main consensus statement on the management of analgesia and sedation for severe COVID-19 patientsTable 1 (Continued): The main consensus statement on the management of analgesia and sedation for severe COVID-19 patientsPain, agitation, delirium, and sleep disturbance are commonly manifested in COVID-19 patients and are closely associated with the severity and poor prognosis of the disease. This expert consensus statement should be helpful for clinicians worldwide with limited experience in the management of analgesia and sedation for severe COVID-19 patients by offering specific suggestions in this time of global crisis. Acknowledgements The authors thank all of the health care workers and other hospital staff as well as the local authorities for their efforts to combat the outbreak of COVID-19. Funding The work was supported by a grant from the China Health Information and Health Care Big Data Society: Special Research Fund for Analgesia and Sedation of Severe Infection (No. Z-2019-1-001). Conflicts of interest None.

Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults.

The prevalence of electronic cigarette (EC) use has risen dramatically among adolescents and young adults (AYA, ages 12-26) over the past decade. Despite extensive established relationships between combustible cigarette use and mental health problems, the mental health comorbidities of EC use remain unclear. To provide a systematic review of existing literature on mental health comorbidities of EC use among AYA. Database searches using search terms related to EC, AYA, and mental health identified 1168 unique articles, 87 of which prompted full-text screening. Multiple authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings. Forty articles met eligibility criteria (n = 24 predominantly adolescent and 16 predominantly young adult). Analyses yielded three main categories of focus: internalizing disorders (including depression, anxiety, suicidality, eating disorders, post-traumatic stress disorder), externalizing disorders (attention-deficit/hyperactivity disorder and conduct disorder), and transdiagnostic concepts (impulsivity and perceived stress). Significant methodological limitations were noted. Youth EC use is associated with greater mental health problems (compared with nonuse) across several domains, particularly among adolescents. Because many existing studies are cross-sectional, directionality remains uncertain. Well-designed longitudinal studies to investigate long-term mental health sequelae of EC use remain needed. Forty recent studies demonstrate a variety of mental health comorbidities with AYA EC use, particularly among adolescents. Mental health comorbidities of EC use generally parallel those of combustible cigarette use, with a few exceptions. Future EC prevention and treatment strategies may be enhanced by addressing mental health.

Pain-Related Anxiety among Adults with Obesity and Chronic Pain: Relations with Pain, Opioid Misuse, and Mental Health

Obesity affect a significant proportion of the population in the United States, and is associated with numerous health consequences including anxiety, depression, and chronic pain. Additionally, pain among adults with obesity has been associated with greater mental health problems and substance use problems. Yet little work has examined psychological vulnerability factors associated with these relations, and pain-related anxiety may be one candidate psychological correlate of these relations. Therefore, the current study examined the association of pain-related anxiety with pain intensity, disability, opioid misuse, anxiety, and depression among 164 adults (81.7% female, Mage = 40.13 years, SD = 10.85) with obesity (MBMI = 37.21, SD = 6.70) and chronic pain. Results suggested that pain-related anxiety was significantly associated with all outcomes, and these results suggest that pain-related anxiety may play an important role in physical health, mental health, and substance use outcomes among adults with obesity and chronic pain.

Reciprocal Causation Between Functional Independence and Mental Health 1 and 2 Years After Traumatic Brain Injury: A Cross-Lagged Panel Structural Equation Model.

The research attempting to disentangle the directionality of relationships between mental health and functional outcomes after traumatic brain injury (TBI) is growing but has yielded equivocal findings or focused on isolated predictors or isolated outcomes. The purpose of the current study was to use cross-lagged panel and structural equation modeling (SEM) techniques to examine causality between comprehensive indices of mental health (depression, anxiety, and life satisfaction) and functional independence in a national sample of individuals with TBI over the first 2 years after injury. Participants were 4,674 individuals with TBI from the TBI Model Systems Database. The SEM, which yielded good fit indices, suggested that individuals with TBI with greater mental health problems at 1 and 2 years after injury had lower functional independence at those same time points. The standardized path loadings for mental health problems and for functional independence over time were large, suggesting a high degree of consistency in mental health and functional independence across 1 and 2 years. In terms of cross-lag, mental health at Time 1 did not exert a unique effect on functional independence at Time 2, but functional independence at Time 1 exerted a statistically significant but quite small unique effect on mental health at Time 2. This combination of results suggests that functional independence is only slightly more causal than mental health in the relationship between mental health and functional independence over the first 2 years post-TBI, and that instead, reciprocal causality is a more likely scenario. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) understand the nature of the relationship between mental health problems and functional independence after traumatic brain injury; (2) learn about a novel methodological technique for examining the connections between variables over time; and (3) understand when ongoing support for individuals with traumatic brain injury is necessary. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

1072 SLEEP TRAJECTORIES FROM ADOLESCENCE TO ADULTHOOD AND THEIR RELATIONSHIP WITH HEALTH OUTCOMES

Sleep is linked to physiological and mental health outcomes. However, little is known about sleep trajectories from adolescence to adulthood and their relationship with health outcomes. We examined sleep trajectories and their relationship with cardiometabolic and mental health in a representative sample over 16 years. We tracked participants between 1997 and 2013 from the Panel Study of Income Dynamics study and the Child Development and Transition into Adulthood Supplements (n=3,118; age 10-17y at baseline) who reported their sleep duration up to six times during the study. We used latent class growth modelling to identify distinct sleep trajectories (long sleep (8.7% of the sample), average sleep (72.5%), and short sleep (18.8%)) and assessed their relationship with self-rated health, high blood pressure, obesity, and mental health using logistic and linear regressions controlling for the year of birth. Compared to the average sleep trajectory, both short and long sleep trajectories were associated with higher odds of poor or fair self-rated health (OR (95% CI), p-value): 1.82 (1.16, 2.84), p=0.01 and 1.89 (0.98, 3.63), p=0.06, respectively). Both short and long sleep trajectories also had greater mental health problems in adulthood (OR 1.66 (1.11, 2.49), p=0.01) and 1.99 (1.07, 3.69), p=0.03), respectively). Only the trajectory of short sleep was associated with higher odds of having high blood pressure (OR 1.81 (1.06, 3.12), p=0.03), greater distress (β (95% CI), p-value: 1.51 (0.73, 2.28), p<0.01) and lower mental well-being (β -0.63 (-1.15, -0.10, p=0.02)) compared to average sleep trajectory. We found no significant association between sleep trajectories and obesity. We found evidence that short and long sleep trajectories from adolescence to adulthood are linked to poor physiological and mental health outcomes in adulthood. Individuals that follow a trajectory of short sleep seemed particularly vulnerable to poor mental well-being as young adults. Additional research is needed to extend our understanding of the relationship between sleep trajectories over the lifespan and their effect health outcomes. GG is supported by a postdoctoral fellowship from the Canadian Institutes for Health Research. FJE is supported by a Canada Research Chairs program.

Adults' Explanations for Intimate Partner Violence During Childhood and Associated Effects.

Exposure to intimate partner violence (IPV) is known to challenge children's optimal development. This study sought to associate participants' beliefs about IPV held during childhood with their adjustment as adults, and to compare their beliefs from childhood to their beliefs in early adulthood. A nationally representative sample of 703 Swedish young adults reported on their past and present beliefs about the causes of their parents' IPV. Standardized measures assessed their mental health (anxiety, depression, and traumatic stress symptoms) and the quality of their relationships as adults. The most common explanations for IPV were that the perpetrator suffered from physical or mental illness, had relationship problems, or was distressed. Participants were less likely to blame themselves for IPV or to believe that the perpetrator was cruel when they were adults, compared to their reports of themselves as children. Women were more likely to attribute mental or physical illness as the cause of the perpetrator's IPV. Childhood beliefs that the perpetrator was debilitated (from mental illness or substance abuse) and cruel (took pleasure in violence and/or despised the child) were associated with greater mental health problems and poorer relationship quality in adulthood. Evaluation of children's harmful beliefs about IPV could be useful in adapting intervention services aimed at ameliorating negative personal causal attributions.

Food insecurity and antiretroviral adherence among HIV positive adults who drink alcohol

Food insecurity is associated with HIV treatment non-adherence and poor health outcomes for people living with HIV/AIDS. Given the poor nutritional status common to people who drink alcohol, food insecurity may be particularly problematic for HIV positive individuals who drink alcohol. To examine food insecurity among HIV positive men and women who drink alcohol and its association with antiretroviral therapy (ART) adherence, health outcomes and health service utilization. Adults living with HIV (N = 183) in Atlanta, Georgia who reported alcohol use in the previous week and were receiving ART participated in a 12-month cohort. Participants were recruited from infectious disease clinics and social services to complete computerized interviews, monthly-unannounced pill counts to monitor ART adherence, and daily cell-phone delivered interactive-text assessments for alcohol use. Forty-three percent of participants experienced food insecurity during at least one month of the study period. Food insecurity was independently associated with suboptimal ART adherence and less suppressed HIV viral load over. Individuals who experienced food insecurity also had histories of more medical and psychiatric hospitalizations, and greater mental health problems. Food insecurity is prevalent among alcohol using people receiving ART and food insecurity is associated with treatment non-adherence, poor health outcomes, and increased medical and psychiatric hospitalizations.

Exploring the associations between coping patterns for everyday stressors and mental health in young schoolchildren

The purposes of this study were to explore the structure of coping with everyday stressors in a young nonclinical population and examine the relationship between coping and mental health. A total of 1324 children from 91 second-grade classes in 35 schools participated. Mental health was assessed using the parent and teacher forms of the Strengths and Difficulties Questionnaire (Goodman, 1997), and coping was assessed by the Kidcope (Spirito et al., 1988) self-report checklist. Exploratory and confirmatory factor analyses suggested a three-factor structure of coping. Latent-variable regression analysis indicated that coping categories including both active and emotional strategies were associated with fewer mental health problems, whereas withdrawal and oppositional coping strategies were associated with greater mental health problems. With some important exceptions, the results replicated previous studies of adults and adolescents. The need for new, more comprehensive coping assessments is highlighted.

Comparing boy and girl arsonists: Crisis, family, and crime scene characteristics

Objective. Juvenile arson offenders have received increasing attention due to the high human and financial cost of arson in the USA. This study examines the similarities and differences between male and female juvenile arson offenders regarding family crisis, school issues, mental health, family characteristics, crime descriptions, and past delinquency. Method. The sample consists of 217 male and 114 female juveniles charged with an arson‐related charge from a large southern state over a 5‐year period from 2000 to 2005. Results. Female juvenile arsonists more often reported a significant crisis within their family in the past year when compared to male juvenile arsonists. Most of the juvenile arson offenders attended school regularly but girls had greater issues with tardiness or truancy than boys. Girl arsonists more often reported a history of childhood abuse, higher scores on a suicide ideation scale and were more likely to set fire at school. Boy arsonists were more likely to have greater mental health problems, report gang involvement, a history of prior delinquency and prior arson, and were found to set fires at their residence when compared to girl arsonists. Instrumental versus expressive reasons for the arson behaviour are discussed. Conclusion. These findings suggest strongly that boy and girls arson offenders are dissimilar enough to require unique assessment and treatment.

Self-reported traumatic brain injury in male young offenders: A risk factor for re-offending, poor mental health and violence?

Adolescence is a risk period for offending and for traumatic brain injury (TBI) and TBI is a risk factor for poor mental health and for offending. TBI has been largely neglected from guidance on managing the mental health needs of young offenders. We sought to determine the rate of self-reported TBI, of various severities, in a male, adolescent youth offending population. We also aimed to explore whether TBI was associated with number of convictions, violent offending, mental health problems and drug misuse. Young male offenders aged 11 to 19 years were recruited from a Young Offender Institute, a Youth Offending Team and a special needs school. A total of 197 participants were approached and 186 (94.4%) completed the study. They completed self-reports on TBI, crime history, mental health and drug use. TBI with loss of consciousness (LOC) was reported by 46% of the sample. LOC consistent with mild TBI was reported by 29.6%, and 16.6% reported LOC consistent with moderate to severe TBI. Possible TBI was reported by a further 19.1%. Repeat injury was common – with 32% reporting more than one LOC. Frequency of self-reported TBI was associated with more convictions. Three or more self-reported TBIs were associated with greater violence in offences. Those with self-reported TBI were also at risk of greater mental health problems and of misuse of cannabis. TBI may be associated with offending behaviour and worse mental health outcomes. Addressing TBI within adolescent offenders with neurorehabilitative input may be important for improving well-being and reducing re-offending.

Mental Health Screening of Female Juvenile Offenders: Replication of a Subtyping Strategy

Recent research indicates that adjudicated female youth have higher rates of mental health problems and histories of trauma exposure and abuse relative to adjudicated male youth. These differences are important for gender-specific assessment, intervention, and management strategies. We replicated a subtyping strategy for adjudicated female youth based on mental health screening data from the Massachusetts Youth Screening Instrument-2 (MAYSI-2) by investigating subtype differences on trauma symptoms, abuse history, and other background variables. Cluster analysis of the standard MAYSI-2 scales revealed a three cluster solution replicating results from a prior study. Additionally, results indicated expected differences between female youth with mental health problems compared to those without mental health problems with co-occurring female youth (i.e., self-reported mental health and substance abuse problems) having have greater mental health problems and more extensive abuse histories compared to other subtypes.

Predictors of Placement on a Jail Mental Health Unit: Assessing Equitable Access to Care

This paper presents findings about the clinical, criminal, and demographic characteristics associated with placement of inmates on the mental health unit of a county jail. Access to intensive mental health services was examined through retrospective review of the health and mental health records of 290 male and female jail inmates. Prior psychiatric treatment, use of greater numbers of illegal drugs, more days in jail, and being female were significantly associated with placement on the mental health unit. Overall, women of all races/ethnicities had greater health and mental health problems as measured by the clinical variables than men of all races/ethnicities.

Caregiving, alcohol use, and mental health symptoms among HMO members.

Using data from a survey of 5841 HMO members, we examined alcohol consumption, depression and anxiety symptoms, and health services use among 689 informal caregivers. Characteristics of caregivers included whom they cared for, types of care provided, number of people cared for, and whether care was provided in the caregiver's home. Outcome measures in hierarchical linear and logistic stepwise regression models included indicators of alcohol drinking pattern, symptoms of anxiety and depression, role limits due to emotional problems and self-reported doctor's visits. Adjusting for age and gender differences, caregivers reported more bodily pain, worse role functioning related to emotional problems, were more likely to screen as depressed, and were more likely to report symptoms of anxiety. Older caregivers, and those with greater vitality, had better mental health outcomes; caregivers with higher levels of education reported better psychological well-being and less interference with role functioning due to emotional problems. Caregivers did not make more doctor's visits than non-caregivers. No caregiving characteristics were consistently associated with both mental health and alcohol consumption outcomes. The relationship of the care recipient to the caregiver predicted mental health outcomes better than either the type of care, number cared for, or location of care. Both the type of care and relationship to the care provider were associated with alcohol consumption, and several gender interactions were identified. Our results confirm previous findings of greater mental health problems among caregivers, yet suggest that caregivers may not be seeking services commensurate to their needs.