Hopkins Symptom Checklist Research Articles

Changes in mental health problems and suicidal behaviour in students and their associations with COVID-19-related restrictions in Norway: a national repeated cross-sectional analysis

ObjectiveThe COVID-19 pandemic has had a devastating impact on higher education, with the closure of student campuses. The aim of this study was to examine changes and prevalence of mental...

Association of pregnancy-related stigma and intimate partner violence with anxiety and depression among adolescents.

We explored the association between pregnancy-related stigma and intimate partner violence (IPV) with depression and anxiety among adolescents in Uganda. We interviewed a convenience sample of 100 adolescents (>18 years) who were pregnant (>3 months) or recently gave birth (<3 months) at Tororo District Hospital, Uganda. Symptoms of depression and anxiety were evaluated using the Hopkins Symptom Checklist (HSCL-25), physical and sexual IPVwere assessed using the WHO violence against women instrument, and pregnancy-related stigma was captured with a questionnaire. Regression models were used to evaluate associations of pregnancy stigma and IPV with depression and anxiety. Mean age was 18 years, 84% were primiparous, 66% were married and 57% had only primary school-level education. About 48% women had clinically meaningful distress levels; 45% reported sexual IPV, 32% physical IPV, and 86% reported experiencing pregnancy-related stigma. Adjusted models showed that higher levels of depression and anxiety were associated with higher report of pregnancy-related stigma (β = .27, p = .03), physical IPV, (β = -.24, p < .01), or sexual IPV (β = -.19, p = .05), compared to those who did not. Unemployment (β = -.24, p = .01) and lower educational level (β = -.21, p = .05) were also independent predictors of depression and anxiety. Findings suggest that IPV is common among adolescents in Uganda, as is pregnancy-related stigma, and both are independent predictors of depression and anxiety. The implications of these findings and the need for clinical interventions for IPV among adolescents are discussed.

Effects of a school-based intervention on levels of anxiety and depression: a cluster-randomized controlled trial of the MindPower program in ten high schools in Norway

BackgroundThe previous decades have shown increased symptoms of depression and anxiety among adolescents. To promote mental health and reduce mental illness, the government of Norway has, as in other countries, pledged that all schools must incorporate life-skills education. We report results from an evaluation of MindPower, a modification of the Coping With Depression (CWD) course, delivered universally in the classroom to secondary high school students, aged 15–16 years, in one county in Norway. The aim of the study was to evaluate the effect of MindPower on symptoms of depression and anxiety.MethodsWe utilized a two-groups` delayed intervention design where 110 first year high school classes were randomized into one of two intervention groups (IG1 and IG2). IG1 participated in MindPower while IG2 served as a control group for four months until the intervention started also in this group. IG1 and IG2 responded to questionnaires before and after the eight weeks course, at the start of the first and the second booster session, and at the five months follow up. Questionnaires, including online versions of the Hopkins Symptom Checklist (SCL-8) and the Reynolds Adolescent Depression Scale (RADS-2:SF), were administered to 1673 out of a total of 2384 students. SCL-levels were also compared with those from a large population study (UngData).ResultsAccording to mixed model analyses, SCL-8 and RADS-2:SF showed significant baseline differences between IG1 and IG2. In IG1 and IG2, both SCL-8 and RADS-2:SF showed a small but significant increase in mean scores throughout the study period, with markedly lower mean scores among boys. The SCL-levels were first lower for both girls and boys and then after the completion of MindPower the SCL-levels, equal to the SCL-levels in UngData.ConclusionsNo effects of the intervention were found. This large universal school-based trial suffered from considerable drop-out of participants. Experiences from implementation and evaluation of universal mental health promotion and preventive school interventions are thoroughly discussed, including, preparation, resources, support, time, realistic expectations, teacher selection and training, implementation, research designs and more. Several empirically based, practical advices are presented.Clinical Trial registration27/08/2018. Registration number NCT03647826.

Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial

BackgroundSyrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an effective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul, Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-effectiveness of the intervention.MethodsRefugees with psychological distress (Kessler Psychological Distress Scale, K10 > 15) and impaired psychosocial functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (n = 24) or E-CAU only (n = 22). gPM+ comprised of five weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identified problems (Psychological Outcomes Profiles, PSYCHLOPS) were included as secondary outcomes. A modified version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses.ResultsThere were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an effect. No significant difference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found.ConclusionsgPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe intervention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCT.Trial registrationClinicalTrials.gov Identifier NCT03567083; date: 25/06/2018.

Reliability and validity of a perinatal depression screening instrument in rural Mali

BackgroundIn order to reduce the burden of perinatal depression in low- and middle-income countries, health systems must be able to identify and treat women suffering from depression. The objective of our study was to develop a locally valid and reliable screening instrument for use in identifying pregnant women and mothers of young children with a local depression syndrome, dusukasi, in rural Mali. MethodsWe administered a locally adapted screening instrument containing items from the Edinburgh Postpartum Depression Scale (EPDS) and Hopkins Symptom Checklist (HSCL-25) to 180 pregnant women and mothers of children under age 2 in Sélingué, Mali to assess the instrument's psychometric properties and validity. Item Response Theory was used to develop an abbreviated version of the measure and the validity and psychometric properties of this shortened version were compared with the full-length scale. ResultsThe full 28-item scale exhibited a single factor structure with good internal consistency (Cronbach's alpha ​= ​0.92). Women who self-identified as suffering from dusukasi (n ​= ​87) in a known groups analysis to assess construct validity had significantly higher depression and anxiety symptom scores (p ​< ​0.0001) and functional impairment scores (p ​< ​0.0001) compared to women not reporting dusukasi (n ​= ​93). The shortened 16-item scale performed as well as the full scale in identifying women with dusukasi. ConclusionsConstruct validity of our adapted screening instrument was supported for identifying dusukasi in rural Malian women. Our methodology can be applied in other settings to develop similarly valid screening instruments for perinatal depression.

Latent class analysis of COVID-19 experiences, social distancing, and mental health.

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes (p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, β = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes (p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cango Lyec (Healing the Elephant): Probable post-traumatic stress disorder (PTSD) and depression in Northern Uganda five years after a violent conflict

BackgroundFrom 1986 to 2006, Northern Uganda experienced an atrocious civil war between the Lord's Resistance Army (LRA) and the Ugandan government. Acholi people living in the region continue to be impacted by trauma sequelae of the war and a wide range of daily stressors including poverty, hunger, and high rates of HIV infection. To date, there is a dearth of gender-differentiated mental health research in this post-conflict setting. The current study aimed to estimate the prevalence of probable post-traumatic stress disorder (PTSD) and depression in three districts most affected by the Northern Ugandan conflict and examine socio-structural, war-related, and sexual vulnerability factors associated with mental health. MethodsCango Lyec (Healing the Elephant) is an open cohort study involving participants from eight randomly selected communities in Amuru, Gulu, and Nwoya districts of Northern Uganda. Between November 2011 and July 2012, the baseline cohort (N = 2,458) completed the Harvard Trauma Questionnaire (HTQ) and Hopkins Symptom Checklist-25 (HSCL-25) for screening PTSD and depression, in addition to a detailed questionnaire assessing socio-demographic-behavioral characteristics. Baseline categorical variables were compared between males and females using Fisher's exact test. Multivariate logistic regression was used to model correlates of probable PTSD and depression. All analyses were stratified by gender. ResultsThe overall prevalence of probable PTSD and depression was 11.7% and 15.2% respectively. Among former abductees, the prevalence was 23.2% for probable PTSD and 26.6% for probable depression. Women were significantly more likely to experience mental distress than men. Factors associated with mental distress included wartime trauma (adjusted odds ratios ranging from 2.80 to 7.19), experiences of abduction (adjusted odds ratios ranging from 1.97 to 3.03), and lack of housing stability and safety (adjusted odds ratios ranging from 1.95 to 4.59). Additional risk factors for women included HIV infection (AOR=1.90; 95% CI: 1.29–2.80), sexual abuse in the context of war (AOR=1.58; 95% CI: 1.02–2.45), and intimate partner violence (AOR=2.45; 95% CI: 1.07–5.63). ConclusionCango Lyec participants displayed lower than previously reported yet significant levels of probable PTSD and depression. Based on findings from this study, providing trauma-informed care, ensuring food and housing security, eliminating gender-based violence, and reintegrating former abductees remain important tasks to facilitate post-conflict rehabilitation in Northern Uganda.

Assessment of Anxiety and Depression among Adult Population of Kashmir, India: A Cross-sectional Study.

Mental health in Kashmir remains a concern and is threatening to become an ever-increasing epidemic. The changing social structure and the low-intensity armed conflict have become the basis of a deteriorating state of mental health among Kashmiris. In addition to this, the other factors are widespread poverty, uncertainty, grief, oppression, fear and high unemployment with limited employment generating sectors. To assess the depression, anxiety and mental distress among the adult population of Budgam district, Kashmir, India. A cross-sectional study was conducted at the community level in District Budgam, Jammu and Kashmir, India, from December 2019 to March 2020. Total three Investigators, one Senior Research Fellow (SRF) and two Junior Research Fellow (JRF) collected the data. The SRF was a Clinical Psychologist while the JRF were trained social workers. A door to door survey was conducted in the villages which were selected randomly from the list of the villages. The probability random sampling technique was used for the research purpose. Hopkins Symptoms Checklist-25 (HSCL-25) was used in the study and whereby after analysing the scores of the scale, results were derived. Chi-square and t-test were applied for statistical comparison. Out of 133 individuals, 55 were males and 78 were females.The age of the sample ranged from 18 to 45 years, with a mean age of 37 years. Total 29.32% of the adults scored above the cut-off for anxiety symptoms and 34.58% scored above the cut-off for depressive symptoms, while 39% of these adults fall above the cut-off for mental distress scores.The validated cut-off score for the anxiety was 1.75 and for the depression was 1.57. Feeling tense, being worried, nervousness and low energy were reported as the symptoms of the mental distress among the people. Females, unemployed and individuals from lower socio-economic status reported higher degree of mental distress than others. Mental health issues in terms of anxiety, depression, and mental distress are found among the adult population in district Budgam. There was a significant mean difference in the mental distress levels concerning various socio-demographic variables. The study concluded that being female, having some medical condition, being unemployed, belonging to lower socio-economic status, belonging to nuclear family predict mental health distress.

Anxiety scale in surgical abortions and drug-induced abortions: A comparative study

Introduction. It is well known that many events during life can be stressful events, specifically events related to health. Abortion is an event that represents a robust risk factor for the development of anxiety symptoms. Induced abortions occur for many reasons, including genetic defect, missed abortion, various diseases of the mother, trauma etc. The impact of abortion (as stressful life events) in the etiology of anxiety disorders has been described in the literature. Anxiety disorders are defined as excessive worry or fear and tension about everyday events and problems or for any sudden stressful life events. Anxiety levels are typically classified into four categories: mild, moderate, severe and panic level anxiety. Objective. The primary objective of the study was to determine the anxiety scale before an induced abortion. Materials and methods. This is a cohort study. The study was conducted at the University Clinical Center of Kosovo, a tertiary care hospital. 189 women participated in the study waiting for abortions. The women were divided into two groups; 87 women designated for surgical abortion and 102 for drug-induced abortion. Both groups were assessed separately for presence and degree of anxiety. To evaluate these two parameters were used Hopkins Symptoms Checklist (HSCL-25). Only the first 10 HSCL-25 questions were used to assess the presence and anxiety scale. The anxiety scale was measured before the abortion. The primary outcome measures studied were the incidence of abortions, the average maternal age, type of induced abortion, presence of anxiety, and anxiety scale. Results. During the study period in our clinic, 1376 pregnant women were hospitalized, out of which 189 cases for abortion. The incidence rate of abortions was 13.7 per 1000 women aged 15-44 years. Of these 189 cases for abortion in both groups, 110 women or 58.2% had anxiety. The mean age of patients was 28.76 ± 6.2 years. Out of 110 cases that experienced anxiety during an induced abortion; 78.2% (86 cases) had mild anxiety, 19.1% (21 cases) moderate anxiety, and 2.7% (3 cases) severe anxiety. A comparison was made between the two groups, and it turned out those women with surgical abortions had a relative risk (RR) OF 1.5 times higher to experience anxiety during abortion procedures than not even women with drug-induced abortions. Anxiety was experienced by women in the form of phobias. Women who underwent surgical abortion mostly had phobias such as; phobia by uncontrollable bleeding (31.7%), followed by phobia by surgical abortion procedures (27%), phobia associated with anesthesia (14.3%), while women who underwent drug-induced abortion mostly had phobias by phobia associated with abortion failure, and likelihood for surgical abortion (44.7%), followed by phobia for developing infections (31.9%) etc. Conclusions. The results of this study show that the incidence of abortions was 13.7 per 1000 women aged 15-44 years. Regardless of the method of abortion, 58% of women experienced anxiety during the abortion procedure. Of these, 78% had low levels of anxiety, 19% moderate and 3% severe anxiety. Findings from our analysis show that women who had abortions with surgical abortions experienced 1.5 times more anxiety than women with drug-induced abortions.

Kepribadian (Five Factor Model) dan Psychological Distress pada Mahasiswa Penerima dan Bukan Penerima Beasiswa

&lt;span lang="EN-GB"&gt;Scholarship recipient students have more demands and responsibilities than non-scholarship students. The demands of lectures can put pressure on students that can trigger psychological distress. Each individual is different in assessing the stress experienced depending on the personality. The research instrument used the NEO Five-Factor Inventory-3 scale and the Hopkins Symptom Checklist-25 scale (HSCL-25). The results of the comparison test show that there is no difference between recipients and non-scholarship recipients. The results of the correlation test show that there is a significant positive relationship between neuroticism and psychological distress, while extraversion and conscientiousness have a significant negative relationship with psychological distress. However, there is no significant relationship between openness to experience and agreeableness to psychological distress.&lt;/span&gt;

Screening for depression in patients in treatment for alcohol use disorder using the Beck Depression Inventory-II and the Hopkins Symptom Checklist-10

Alcohol use disorder (AUD) and major depressive disorder (MDD) are prevalent disorders that often co-occur. The aim of the study was to investigate how the Beck Depression Inventory (BDI-II) and Hopkins Symptom Checklist (HSCL-10) perform as screening instruments for MDD in AUD patients in treatment. The study included 127 mainly AUD inpatients currently in treatment at rehabilitation clinics in Norway. Demographic and clinical variables were examined using questionnaires and clinical interviews. The factor structures of the BDI-II and HCSL-10 were examined, as well as internal consistency and receiver operating characteristic (ROC) curve analyses. The Mini International Neuropsychiatric Interview (M.I.N.I.) was used as standard for diagnosing MDD. In total, 14% of the participants were diagnosed with MDD. BDI-II factor analysis retrieved three factors; cognition, somatic complaints and affect, and factor analysis for the HSCL-10 retrieved two factors; depression and anxiety. The optimal cut-off for the BDI-II was 24.5 with sensitivity of 80% and specificity of 78%. For HSCL-10 the optimal cut-off was 2.35, giving sensitivity of 80% and specificity of 69%. Both the BDI-II and HSCL-10 may be clinically useful screening instruments for MDD in AUD patients. There was a tendency that the affect factor of the BDI-II and the depression factor of the HSCL-10 were slightly more suitable for identifying MDD than the other factors. Optimal cut-offs for both the BDI-II and the HSCL-10 in this patient group were higher than cut-offs commonly used in the general population.

Association of Dual Sensory Impairment with Long-term Depressive and Anxiety Symptoms

Family members of persons diagnosed with dementia or a traumatic brain injury (TBI) are often relied upon to provide daily support to their care recipients. However, research on the differing experiences of caregivers based on care recipient diagnosis is limited. The aim of this study was to examine the impact of worry and feelings of vigilance among caregivers of people with cognitive impairment due to either TBI or dementia. This sample included 61 caregivers (88.5% female, mean age 57.3±15.5) of persons with either a TBI (n = 32) or dementia (n = 29). Worry was assessed with the Penn State Worry Questionnaire and Vigilance was assessed with the Caregiver Vigilance Scale. Linear regressions revealed that after controlling for age, care recipient diagnosis moderated the relationship between worry and caregiver vigilance. Specifically, worry was significantly associated with caregiver vigilance in those caring for someone with dementia; however, a similar relationship was not seen in those caring for someone with a TBI. This suggests caregivers of people with TBIs have a different experience of worry and vigilance than caregivers of people with dementia. These findings demonstrate the need for more research on the unique needs of caregivers of people with TBIs. Additionally, this research suggests interventions targeting worry may be particularly effective in supporting caregivers of people with TBIs.

Association between psychosocial distress, sexual disorders, self-esteem and quality of life with male androgenetic alopecia: a population-based study with men at age 46

ObjectivesTo study the association between androgenetic alopecia (AGA) and its severity with psychosocial well-being in male subjects aged 46 years at the population level.DesignCross-sectional study.SettingThe Northern Finland Birth Cohort 1966...

Dental anxiety and potentially traumatic events: a cross-sectional study based on the Troms\xf8 Study\u2014Troms\xf8 7

ObjectiveThe objectives of the study were to describe the prevalence of dental anxiety and the possible associations between dental anxiety and potentially traumatic events in an adult population.MethodThe study is based on cross-sectional questionnaire data from the 7th wave of the Tromsø Study, a study of the adult general population in the municipality of Tromsø carried out in 2015–2016. The Modified Dental Anxiety Scale was used to measure dental anxiety across potentially traumatic events, oral health, dental attendance (avoidance) and current mental health symptoms (Hopkins Symptom Checklist). Individuals with high and low dental anxiety scores were compared to investigate differences in the distribution of potentially traumatic events, current mental health symptoms, avoidance, sex and oral health, and hierarchical multivariable regression was used to study the influence of traumatic events on dental anxiety.ResultsHigh dental anxiety was reported by 2.9% of the sample and was most prevalent among females and in the youngest age groups. Individuals with high dental anxiety reported more current mental health symptoms, and they were more likely to report poorer oral health and more irregular dental visits compared to individuals with no or lower dental anxiety scores. Concerning traumatic events, the reporting of painful or frightening dental treatment showed the biggest difference between those with high dental anxiety and low dental anxiety scores (a moderate effect). The hierarchical regression model indicated that reporting sexual abuse, traumatic medical treatment in hospital and childhood neglect significantly predicted dental anxiety in the step they were entered in, but only sexual abuse remained a significant individual contributor after controlling for current mental health symptoms.ConclusionsThe prevalence of high dental anxiety was lower than expected (2.9%), but dentally anxious individuals expressed a high burden of mental health symptoms, poor oral health and the avoidance of dental care. The regression analysis indicated that experiences with sexual abuse could affect dental anxiety levels in the absence of generalised symptoms of anxiety and depression.

The association between abusive supervision and anxiety in female employees is stronger in carriers of the CRHR1 TAT haplotype

• In the general working population men report less anxiety than women. • The score of anxiety is associated with the exposure to abusive supervision. • Anxiety induced by abusive supervision is influenced by the CRHR1 genotype. • CRHR1 TAT/TAT in women increases the risk of anxiety induced by abusive supervision. Previous findings suggest that exposure to social stress in the form of abusive supervision may increase the risk of anxiety disorders. In the present study, we examined the link between abusive supervision, the CRHR1 genotype and anxiety. The data was collected through a national survey drawn from the National Central Employee Register by Statistics Norway. A total of 1225 individuals returned both the questionnaire and the saliva kit. Abusive supervision was assessed with 5 items from the Tepper's “Abusive Supervision Scale”. Anxiety was measured by 5 items of the “Hopkins Symptom checklist”. Genotyping with regard to CRHR1 rs7209436 C/T, rs110402 G/A and rs242924 G/T was carried out using Taqman assay, and Phase v.2.1.1 was used to define the CRHR1 haplotype TAT versus CGG. The analyses revealed that abusive supervision was associated with anxiety. In particular, we observed a strong effect of abusive supervision on anxiety in female TAT/TAT carriers ( p = 0.000). Moreover, using TAT/TAT as a reference, TAT/CGG and CGG/CGG both showed protective effects ( p = 0.015, p = 0.001, respectively). Thus, the association between abusive supervision and anxiety was strong among female TAT/TAT carriers was stronger than among female TAT/CGG and female CGG/CGG carriers. No such gene-environment interaction was seen in men. Our data demonstrated that the CRHR1 TAT haplotype may exacerbate, whereas the CRHR1 CGG haplotype may reduce, the effect of abusive supervision on anxiety in female employees. Hence, the present study supports the theory that both gender and the CRHR1 genotype, moderate the responses to social stressors.

Childhood abuse and its association with adults’ mental health problems: a cross-sectional study among men and women in the Yangon Region of Myanmar

ObjectivesTo estimate the prevalence of emotional, physical and sexual childhood abuse, and symptoms of post-traumatic stress disorder (PTSD) and to examine the association between childhood abuse and adult mental health...

Sexual Harassment in Fitness Instructors: Prevalence, Perpetrators, and Mental Health Correlates.

Introduction: This paper explores frequency of experiences of sexual harassment (SH) among fitness instructors, outlines the typical perpetrator, and explores associated mental health symptoms.Design: Cross-sectional survey.Materials and Methods: A total of 270 Norwegian fitness instructors, recruited in social media, responded to an electronic questionnaire in 2019/2020 on experiences of body appearance pressure, SH, and mental health symptoms. Outcomes included in this publication are experiences of SH, and symptoms of mental health issues based on the Hopkins symptom checklist, SCL-10; Beck Depression Inventory, BDI-1a; and Eating Disorder Examination Questionnaire, EDE-q.Results: The frequencies of SH experiences were 30% among 211 women and 22% among 59 men, respectively, with customers being the most frequent source of such approaches and personal trainers (PTs) more often reporting such experiences compared to group instructors (GIs) and to those operating as both PT and GI. Women having experienced SH had significantly higher scores in symptoms of depression, anxiety, and eating disorders compared to women with no such experience.Conclusion: The high frequency of SH experiences among fitness instructors, with customers emerging as perpetrators and typically in the context of personal training, necessitates increased awareness of SH in the fitness industry. To reduce the occurrence of SH, the fitness centers need to communicate countermeasures with high level of compliance.

Using the Rasch measurement theory to assess the psychometric properties of the Hopkins Symptom Checklist-10 in adolescents

BackgroundThe Hopkins Symptom Checklist-10 (HSCL-10) is widely used to measure psychological distress in adolescents. To provide valid and reliable results and generate recommendations for practice and policies, instruments with sound psychometric properties are required. The purpose of this study is to use Rasch measurement theory to assess the psychometric properties of the HSCL-10 among adolescents aged 13–19.MethodsIn this cross-sectional study, 6445 adolescents responded to a web-based questionnaire. Data were collected from lower and upper secondary schools in Norway during 2018. The data were analysed using the partial credit parameterisation of the unidimensional Rasch model.ResultsHSCL-10 was found to be unidimensional and to have acceptable reliability. One pair of items showed response dependency. The targeting of the instrument could have been better. All items had ordered thresholds. Three items under-discriminated and three displayed differential item functioning regarding gender.ConclusionsHSCL-10 has potential for measuring psychological distress in adolescents, though there is room for improvement. To further improve this instrument, some items should be rephrased.

Mental Distress, Help Seeking, and Use of Health Services Among University Students. The SHoT-Study 2018, Norway.

Background: Existing studies have documented high levels of mental distress in University and college students, complemented with poor help-seeking behavior. Colleges and universities offer a unique setting to address mental health problems that might overcome some of the most prominent barriers to help-seeking.Objective: We aim to describe the use of campus-based health care services and health services available in the near-by community among students in Norwegian student welfare organizations. We compare health care service use between non-local (in-movers) and local students, students at large and small welfare organizations, and students with severe and medium-low levels of mental distress.Methods: Data stem from the SHoT study (Students' Health and Well-being Study), a national survey from 2018 of all students aged 18–35 undertaking higher education in Norway. Mental distress was assessed using the Hopkins Symptom Checklist-25 (HSCL-25), and we also obtained self-report data on use of health care services. Data on health care services offered at Norwegian student welfare organizations was obtained from semi-structural telephone interviews.Results: Non-local students used health care services that are low threshold, easily accessible and close to campus (health clinics and services organized by the student welfare organization) to a larger extent than local students. Students with symptoms of severe mental distress used almost all types of health services more than other students. We found big differences in reported use of health services in large and small organizations, yet these differences mirrored services available, and not necessarily student demand and preferences.Conclusion: Services offered by the student welfare organizations seem to play a particularly important role for non-local students and students reporting symptoms of severe mental distress.

Internalized stigma, depressive symptoms, and the modifying role of antiretroviral therapy: A cohort study in rural Uganda

Depression affects over 40% of people with HIV (PHIV) in low- and middle-income countries, and over half of PHIV report HIV-related internalized stigma. However, few longitudinal studies of PHIV have examined the relationship between HIV-related stigma and depression. Data were analyzed from the 2007-15 Uganda AIDS Rural Treatment Outcomes (UARTO) Study, a cohort of 454 antiretroviral therapy (ART)-naïve PHIV (68% women) starting ART. Our primary outcome was depression symptom severity over the first two years of ART, measured using a locally adapted version of the Hopkins Symptom Checklist; our primary exposure was the 6-item Internalized AIDS-Related Stigma Scale. Both scores were measured at enrollment and at quarterly follow-up visits. We fit linear generalized estimating equations (GEE) regression models to estimate the association between stigma and depression symptom severity, adjusting for potential confounders. We included a stigma ​× ​time product term to assess the modifying effect of ART on the association between internalized stigma and depression symptom severity. UARTO participants had a median age of 32 years and median enrollment CD4 count of 217 ​cells/mm3. Both depression symptom severity and internalized stigma declined on ART, particularly during the first treatment year. In multivariable regression models, depression symptom severity was positively associated with internalized stigma (b ​= ​0.03; 95% confidence interval [CI], 0.02 to 0.04) and negatively associated with ART duration >6 months (b ​= ​−0.16; 95% CI, −0.19 to −0.13). The estimated product term coefficient was negative and statistically significant (P ​= ​0.004), suggesting that the association between internalized stigma and depression symptom severity weakened over time on ART. Thus, in this large cohort of PHIV initiating ART in rural Uganda, depression symptom severity was associated with internalized stigma but the association declined with time on ART. These findings underscore the potential value of ART as a stigma reduction intervention for PHIV, particularly during early treatment.