Long-term Mental Health Problems Research Articles

Making meaning of one's own life story in words and images: A narrative case report of personal recovery from personality disorder through the interventions "An Empowering Story" and art therapy.

Understanding and processing life experiences are essential in the treatment of personality disorders to promote personal recovery and psychological wellbeing. In this qualitative case report, drafted in co-creation between the client, clinical psychologist, and art therapist, individual treatment consisted of two psychotherapeutic interventions, "An Empowering Story" and life-story-focused art therapy, in 12 parallel sessions for 24 weeks. Hilda, 68 years of age, had been diagnosed with an unspecified personality disorder and various traits of borderline personality disorder. She experienced emotional exhaustion following long-term mental health problems rooted in a traumatic early childhood. This affected her ability to manage her emotions and social relations, resulting in the sense that her life had no meaning. Hilda was invited to reconstruct her life experiences, divided into the past, turning point, and present/future, in a written and a painted life story. This allowed for the integration of traumatic as well as positive memories, enhanced self-compassion, and meaning making. She developed self-reflection and integration of internal conflicts leading to a better emotional balance and self-understanding. Art therapy emphasizes bottom-up regulatory processes, while narrative psychology supports top-down regulatory processes. The combined approach effectively integrated bottom-up, experiential, sensory experiences with top-down, cognitive emotion-regulation processes. The results suggest that psychotherapeutic interventions involving a multi-pronged, complementary, and thus more holistic approach can support personal recovery in personality disorders.

Schools as critical settings for mental and behavioral health efforts in the United States: Key initiatives for substantive impact

In this article we propose that nation-wide investment in mental and behavioral health (MBH) prevention efforts in public schools has the potential for powerful impact on developmental MBH in the United States (U.S.). We first provide an overview of the structure of public school systems in the U.S. Next, we apply the multi-tiered support system (MTSS) public health model to propose three key initiatives for optimal promotion of youth MBH through public schools in the U.S.: (a) universal access to high quality pre-kindergarten, (b) universal evidence-based social and emotional learning across all grades, and (c) universal MBH screening accompanied by tiered targeted and intensive support services. Within each proposed initiative, we summarize the evidence base and consider barriers and facilitators to implementation. We conclude that public schools in the U.S. represent an optimal place to promote children's and adolescents’ MBH in ways that prevent long-term mental and behavioral health problems.

Improving child nutrition in disasters by developing a modeled disaster preparedness nutrition education curriculum.

In contemporary global society, largely because of climate change and other natural and human-induced hazards, disasters are an almost daily occurrence. The nutritional impact of disasters on children results in long-term physical and mental health problems. As children are one of the most vulnerable demographic groups, they must be empowered with disaster preparedness nutrition knowledge, and the skills and motivation to survive, prevent/reduce malnutrition, and maintain good health during disasters. A disaster preparedness nutrition education program (DPNEP) was developed in this study to improve children's nutrition in daily life and during disasters through student-centered education. A consultative approach was used to synthesize the knowledge of a diverse group of four experts in disaster medicine and management, public health, education, and food and nutrition sciences to reach a consensus through discussion. A model DPNEP was developed by targeting grade 4 and 5 students and using interactive teaching methods. This can lead to the implementation of continuous nutrition education to empower children to make healthy food choices in daily life and reduce the risk of disaster-nutrition-related morbidity and mortality. Furthermore, once children acquire the necessary information, they are likely to share this knowledge with their families and communities, thereby enhancing society's resilience.

Lifetime Experience of Childhood Abuse and Neglect Among High School Students at Debre Tabor Town, South Gondar Zone, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

Childhood abuse and neglect is defined as any intentional harm or mistreatment of a child that results in actual or potential harm to the child's health, survival and development. It has been linked to an increased risk of a wide range of serious short- and long-term medical and mental health problems. Although it is a complex societal issue, it receives limited research attention in the area. To assess lifetime prevalence of childhood abuse and neglect among high school students in Debre Tabor town, south Gondar Zone, Northwest Ethiopia, 2022. A cross-sectional study design was used to assess 423 high school students, chosen through a systematic sampling technique. Data were collected using a pre-tested, structured and self-administered international child abuse screening tool, child version (ICAST-C). The effect of independent variables on the outcome variable was explored using logistic regression analyses. The level of significances were determined using an odds ratio with a 95% confidence interval. Of the 423 study participants, 84.4% had lifetime experience of childhood abuse and neglect. Being female (AOR=4.5, 95% CI: 2.38, 8.60), parental marital status (AOR=5.4, 95% CI: 1.07, 27.3), illiteracy of father (AOR=1.65, 95% CI: 4.5, 6.03), birth order (AOR=4.5, 95% CI: 1.57, 13.0), open family discussion of sexual matters (AOR=0.37, 95% CI:1.74, 7.86), and watching pornography (AOR=0.08, 95% CI: 0.02, 0.40) were significantly associated with lifetime experience of childhood abuse and neglect. Lifetime experience of childhood abuse and neglect was high as compared with previous studies. Being female, parental marital status, illiterate fathers, watching pornography, and open family discussion of sexual matters were predictors of childhood abuse and neglect. Dealing with this issue should be considered an integral component of high school students' care, including parental education and respite care.

Longitudinal changes in children's and adolescents' mental health and well-being and associated protective factors during the COVID-19 pandemic.

The COVID-19 pandemic has heightened children's and adolescents' risk of experiencing long-term mental health problems and a decline in subjective well-being. To better understand the longitudinal impact of COVID-19, this study explored the role of demographic variables and the potential moderating effects of social support and daily routines as resilience factors. A nationally representative, longitudinal cohort of 5,217 Israeli children and adolescents aged 10-15 at baseline completed measures of mental health symptoms, life satisfaction, positive and negative emotions, gratitude, social support, and daily routines. Data were collected in school at four measurement points: September 2019 (before the outbreak of COVID-19; N = 5,127), May 2020 (after the first lockdown; N = 4,698), May 2021 (after the third wave lockdown; N = 4,813), and May 2022 (after the fourth and fifth waves of the pandemic; N = 4,897). The data were analyzed using multilevel mixed models. Significant increases in depression, anxiety, and panic along with decreases in psychological well-being were found as a function of time. These effects were moderated by age and gender. Participants with high social support and structured daily routines reported smaller increases in mental health symptoms than students with low social support or irregular daily routines. There is a critical need for clinical and educational interventions for young people during this period to promote the resilience factors that can moderate well-being and counter the decline in mental health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Challenges, Complexity, and Developments in Transition Services for Young People with Disabilities, Mental Health, and Long-Term Conditions: An Integrative Review

ABSTRACT Transition to adulthood for young people is complex and multi-faceted, with additional hurdles for young people who have disabilities, long-term, or life-limiting conditions or mental health problems. The challenges in providing effective transition support are not new; researchers, policymakers, commissioners, and service providers have been grappling with the problem for several decades, with varying degrees of success. The aims of this integrative review were firstly to build on previous research to synthesize and evaluate recently published evidence. Secondly to provide an overview of the effectiveness of interventions (in one or a combination of health, social care, and education transitions) designed to support transition to adulthood in these groups of young people. A search of a range of databases retrieved published literature from January 2015 to January 2021 demonstrating global interest in the topic. Fifty-one articles were included following an appraisal of quality and eligibility. Qualitative, quantitative, mixed methods studies, and evidence synthesis were included. Some studies were clinically orientated whilst others examined the impact of the transition process, or utilized participatory approaches which give young service-users and families a voice. Transition between children’s and adult health or care services as well as other life-course trajectories, such as life-skills development, education transitions, social inclusion and employability were evaluated. Thematic analysis and synthesis of articles retrieved in this review highlighted themes identified in previous reviews: timing of, and preparation for transition; perceptions and experience of transition; barriers and facilitators; transition outcomes. Additional themes included special considerations; dealing with complexity; advocacy, participation, autonomy, aspirations, and young people’s rights; future work, research, and evaluation. Novel perspectives and diverse data sources contributed to holistic understanding of an ongoing priority for international policy, service development, and research: the complexity of providing effective transition support and achieving positive outcomes for young people with long-term and life-limiting health conditions, disabilities, and mental health difficulties.

The impact of the Covid-19 pandemic on postnatal depression: analysis of three population-based national maternity surveys in England (2014-2020).

Few studies have evaluated postnatal depression before and during the Covid-19 pandemic using comparable data across time. We used data from three national maternity surveys in England to compare prevalence and risk factors for postnatal depression before and during the pandemic. Analysis was conducted using population-based surveys carried out in 2014 (n=4571), 2018 (n=4509), and 2020 (n=4611). Weighted prevalence estimates for postnatal depression (EPDS score ≥13) were compared across surveys. Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for the association between sociodemographic, pregnancy- and birth-related, and biopsychosocial factors, and postnatal depression. Prevalence of postnatal depression increased from 10.3% in 2014 to 16.0% in 2018 (difference=+5.7% (95% CI: 4.0-7.4); RR=1.55 (95% CI: 1.36-1.77)) and to 23.9% in 2020 (difference=+7.9% (95% CI: 5.9-9.9); RR=1.49 (95% CI: 1.34-1.66)). Having a long-term mental health problem (aRR range=1.48-2.02), antenatal anxiety (aRR range=1.73-2.12) and antenatal depression (aRR range=1.44-2.24) were associated with increased risk of postnatal depression, whereas satisfaction with birth (aRR range=0.89-0.92) and social support (aRR range=0.73-0.78) were associated with decreased risk before and during the pandemic. This analysis indicates that Covid-19 had an important negative impact on postnatal women's mental health and may have accelerated an existing trend of increasing prevalence of postnatal depression. Risk factors for postnatal depression were consistent before and during the pandemic. Timely identification, intervention and follow-up are key to supporting women at risk, and it is essential that mechanisms to support women are strengthened during times of heightened risk such as the pandemic. NIHR Policy Research Programme.

Qigong for the mental health of teachers – A prospective randomized controlled trial

The development of mental health care has changed greatly from ancient civilisations to the present day. Today, teachers' mental health and well-being are in a precarious state, and when lack of training is added, it becomes clear how difficult it is for teachers to provide adequate support to students. This can be exacerbated by specific contexts and cultures in which teachers may feel uncomfortable seeking help. The lack of support for teachers can lead to the development of long-term mental health problems, with negative personal, professional, and social consequences. Because teacher well-being directly impacts student well-being, achievement, and success, it is crucial to promote teachers' mental health. Qigong may be considered a patient-guided psychophysiological feedback technique that enables subjects to learn and control bodily functions and processes. The present study aimed to investigate the potential impact of Qigong on teachers' anxiety, depression, and stress levels, and to explore the feasibility of integrating it into the school context. Eighty-four participants were recruited and randomly divided into two groups. The experimental group received the Qigong intervention and the control group received a placebo intervention, both for 4 weeks. The outcomes were anxiety, depression and stress levels and were assessed using various scales and complementary physiological parameters. Regarding anxiety, the experimental group showed significant improvements in all outcome measures, while the placebo group showed similar scores in the pre- and post-measurements. The post-intervention results even showed a significant difference between the two groups in terms of state anxiety. In terms of depression and stress, the results suggest that Qigong can significantly improve symptoms. The placebo group showed no significant changes. However, no significant differences were found between the groups in the final assessment. The results of this study suggest that Qigong can help improve teachers' mental health and can be implemented in schools.

Bisexual People Experience Worse Health Outcomes in England: Evidence from a Cross-Sectional Survey in Primary Care

ABSTRACT Persistent inequalities in relation to health outcomes continue to exist among patients identifying as lesbian, gay, and bisexual (LGB), and very little is known about outcomes specific to bisexual populations. This study’s aim was to compare the health of individuals identifying as LGB with heterosexual counterparts within primary care in England. Cross-sectional survey data from the year 10 (2015/2016) English General Practice Patient Survey (GPPS) dataset, which consisted of 836,312 responses (38.9% response rate), including 23,834 people who identified as gay, lesbian, bisexual or “other” was analyzed. Health outcomes were assessed through self-reported quality of life, physical and mental health, and confidence in managing own health. Multifactorial logistic regression (adjusting for age, ethnic group, working status, and socioeconomic status) were conducted. Long-term physical and mental health problems were more than twice as likely to be reported for people within LGB groups compared to the heterosexual group for both genders, except bisexual women where the odds were more than four times greater (OR = 4.275, 95% CI, 3.896, 4.691; p < .001). Bisexual women were half as likely to report the absence of a long-term health problem (OR = 0.452, 95% CI 0.419, 0.488; p < .001). LGB groups across both genders, reported a higher proportion of individuals that did not feel confident in managing their health and experienced significantly worse quality of life compared to heterosexuals. LGB patients consistently report poorer health outcomes than heterosexual patients. Bisexual people of both genders consistently experienced worse physical and mental health outcomes compared with the other recorded sexual orientations.

Prevalence and risk factors for postnatal mental health problems in mothers of infants admitted to neonatal care: analysis of two population-based surveys in England

BackgroundPrevious research suggests that mothers whose infants are admitted to neonatal units (NNU) experience higher rates of mental health problems compared to the general perinatal population. This study examined the prevalence and factors associated with postnatal depression, anxiety, post-traumatic stress (PTS), and comorbidity of these mental health problems for mothers of infants admitted to NNU, six months after childbirth.MethodsThis was a secondary analysis of two cross-sectional, population-based National Maternity Surveys in England in 2018 and 2020. Postnatal depression, anxiety, and PTS were assessed using standardised measures. Associations between sociodemographic, pregnancy- and birth-related factors and postnatal depression, anxiety, PTS, and comorbidity of these mental health problems were explored using modified Poisson regression and multinomial logistic regression.ResultsEight thousand five hundred thirty-nine women were included in the analysis, of whom 935 were mothers of infants admitted to NNU. Prevalence of postnatal mental health problems among mothers of infants admitted to NNU was 23.7% (95%CI: 20.6–27.2) for depression, 16.0% (95%CI: 13.4–19.0) for anxiety, 14.6% (95%CI: 12.2–17.5) for PTS, 8.2% (95%CI: 6.5–10.3) for two comorbid mental health problems, and 7.5% (95%CI: 5.7–10.0) for three comorbid mental health problems six months after giving birth. These rates were consistently higher compared to mothers whose infants were not admitted to NNU (19.3% (95%CI: 18.3–20.4) for depression, 14.0% (95%CI: 13.1–15.0) for anxiety, 10.3% (95%CI: 9.5–11.1) for PTS, 8.5% (95%CI: 7.8–9.3) for two comorbid mental health problems, and 4.2% (95%CI: 3.6–4.8) for three comorbid mental health problems six months after giving birth. Among mothers of infants admitted to NNU (N = 935), the strongest risk factors for mental health problems were having a long-term mental health problem and antenatal anxiety, while social support and satisfaction with birth were protective.ConclusionsPrevalence of postnatal mental health problems was higher in mothers of infants admitted to NNU, compared to mothers of infants not admitted to NNU six months after giving birth. Experiencing previous mental health problems increased the risk of postnatal depression, anxiety, and PTS whereas social support and satisfaction with birth were protective. The findings highlight the importance of routine and repeated mental health assessments and ongoing support for mothers of infants admitted to NNU.

Blunted neurobiological reactivity and attentional bias to threat underlie stress-related disorders in women survivors of intimate partner violence.

Intimate partner violence (IPV) alters women's neurobiological stress response systems. We propose that individual differences early in the attentional processing of threats are associated with these neurobiological mechanisms and contribute to mental illness in this population. We assessed attentional bias in relation to threat (AB) in women survivors of IPV (n = 69) and controls (n = 36), and examined overall cortisol secretion using hair cortisol (HC), and stress responsiveness measuring salivary cortisol and α-amylase (sAA) before (T0), and after (T1, T2) an acute psychosocial stress task (Trier Social Stress Test). We used repeated-measures ANCOVAs to explore the associations between Group (IPV, control) and AB with acute stress response, and regression models to examine the associations with mental health symptoms. There were no between-group differences in HC levels. An interaction between Group and AB was found regarding cortisol reactivity (p < 0.05). IPV women with threat avoidance AB showed a blunted cortisol response compared to controls and to IPV participants with threat vigilance AB. The association between sAA reactivity and the interaction between Group, AB, and time approached significance (p = 0.07), with a trend to lower sAA levels particularly in IPV women with threat avoidance AB. Group and cortisol reactivity were associated with symptoms of depression, generalized anxiety, and post-traumatic stress disorder (8-20% explained variance). Threat avoidance AB is associated with blunted acute cortisol response among women exposed to chronic stress (IPV). Experiencing IPV and acute cortisol response appear to be clearly implicated in long-term mental health problems.

Profiles of parent emotion socialization: Longitudinal associations with child emotional outcomes

BackgroundFew studies within the field of emotion socialization have used a person-centered approach to investigate how supportive or unsupportive parent subpopulations influence child development over time. Furthermore, the role of parents’ emotion socialization processes at different child developmental stages remains understudied. ObjectivesThe current study tests whether parent profiles of emotion socialization are associated with concurrent and long-term child mental health problems and emotion competence, and whether associations differ for parents of children in early (4-6 years) versus middle childhood (7-10 years). MethodThree waves of annual data were drawn from the Child and Parent Emotion Study, a longitudinal study of multinational families (n = 869). We drew on previously derived profiles from a latent profile analysis describing ‘emotion coaching’, ‘emotion dismissing’, and ‘emotion disengaged’ profiles of parent emotion socialization. Linear regression models tested associations between parent profiles (assessed in 2019) and child internalizing and externalizing problems, negative affect, and child emotion regulation, assessed 0, 1, and 2 years later (2019-21). ResultsEmotion dismissing (versus emotion coaching) was associated with higher concurrent child internalizing problems, externalizing problems, and negative affect; and longitudinally with higher internalizing problems and negative affect, and lower emotion regulation. Emotion disengaged (versus emotion coaching) was associated with higher concurrent and longitudinal child negative affect, and lower longitudinal emotion regulation. Split by child age, we found stronger associations in early compared to middle childhood for emotion dismissing and child externalizing problems. The reverse was evident for emotion disengaged, where associations were stronger/more evident in middle compared to early childhood for child negative affect and emotion regulation. Other associations were no longer evident or were consistent across child ages. ConclusionChildren of parents who have a pattern of emotion dismissing or emotion disengaged emotion socialization are at greater risk for mental health problems and lower emotion competence.

Intimate partner sexual violence during pregnancy and its associated factors in Northwest Ethiopian women.

Violence against women is a global problem. In pregnant women, it is a particular concern as a virtue of the additional risks to the unborn child. Of different acts of violence, sexual violence shares the major contribution that results in short and long-term physical, sexual, reproductive, and mental health problems of pregnant women. Little is known about sexual violence during pregnancy in Ethiopia. this study aimed to assess the proportion and factors associated with intimate partners' sexual violence against pregnant women in Northwest Ethiopia. A cross-sectional study was conducted among 409 pregnant women in Debre Markos town from March to April 2018. The study participants were selected using a systematic random sampling technique. A pre-tested and validated questionnaire was used. Binary logistic regression analyses were done to identify associated factors and the adjusted odds ratio (AOR) with its 95 % confidence interval (CI) at a p-value of <0.05 was used to declare a significant association. Of 409 pregnant women, 19.8% have experienced sexual violence by their intimate partner during their current pregnancy. Accordingly, the major intimate partner sexual violence during pregnancy was having unwanted sexual intercourse due to fear from the partner (13.4%), being forced to do something sexual that is degrading or humiliating (13.0%), and being physically forced to have sexual intercourse (9.8%). Living with her partner/husband (AOR: 3.73, 95% CI: 1.30, 10.69), uneducated educational status of partner (AOR: 2.43, 95% CI: 1.06, 5.56), and frequency of alcohol consumption (AOR: 3.20, 95% CI: 1.24, 8.26) were factors associated with increased occurrence of intimate partner sexual violence during pregnancy. The proportion of sexual violence against pregnant women by their intimate partner(s) was found to be common in our study. Socio-demographic and behavioral-related factors were risk factors for sexual violence. As a result, preventive strategies and interventions centering on the empowerment of those facing the greatest barriers to reproductive freedom require a shift from traditional ways of thinking.

Abdominal Injuries from Civilian Conflicts: An Emerging Global Health Challenge in Rural Southeast Nigeria.

In recent time, incidence of abdominal injuries continues to increase steadily in most major regions of West Africa due to emergence of various religious, social and political conflicts. Indeed, violence and social conflicts constitute major global public health challenges that commonly lead to injuries and long-term physical and mental health problems. In our setting, increasing cases of abdominal trauma resulting from civilian violence led to additional workload in the general surgery unit and the audit of our experiences is presented in this paper. To analyze the etiological spectrum, trend and management outcome of abdominal injuries from civilian violence in our setting. This was a multicenter prospective study of adult patients with abdominal injuries from civilian conflicts managed at three selected district hospitals in Southeast Nigeria between January 2013 to December 2020. Of 398 patients evaluated, 359 (90.2%) sustained penetrating while 39 (9.8%) had blunt abdominal injuries. Gunshot was the most common mechanism, accounting for 248 (62.3%) cases, followed by stab wound (95, 23.9%). Armed robbery attack (68, 27.4%) was the main source of gunshot wounds. Overall, annual rates showed a four-fold rise over an eight-year period from 24 cases (6.0%) in 2013 to 96 (24.1%) in 2020. Majority (365, 91.7%) had operative management (OM); the rest (33, 8.3%) were treated non-operatively. Morbidity and mortality rates for operative cases were 29.6% and 12.1% respectively. The main factors associated with increased mortality rates were delayed presentation (p = 0.002), bowel resection (p = 0.006), gunshot wounds (p = 0.013), advanced age (p = 0.033), multiple visceral injury (p = 0.034) and ASA score ≥ III (p = 0.001). Abdominal trauma from civilian violence is on the steady rise in our setting. The main etiologic factors are armed-robbery, communal clashes, political thuggery and cultism perpetrated predominantly through gunshots and stab wounds. Advancing age, gunshot wounds, delayed presentation, bowel resection and multiple injuries were associated with increased mortality.

Factors associated with bullying victimization among adolescents joining public secondary schools in Nairobi county Kenya: A cross-sectional study

BACKGROUNDBullying victimization in adolescence exposes young people to both short- and long-term mental health problems. These include depression and suicidality, whose prevalence has been on the rise around the world. Bullying, though officially banned in Kenyan secondary schools since 2013, has remained ubiquitous to the present day. This study aimed to elucidate the factors associated with bullying victimization among adolescents joining Form one at public secondary schools in Nairobi County, Kenya.METHODOLOGYThis was an analytical cross-sectional design. Data were collected one month after the adolescents had joined secondary school. Data was collected from 539 adolescents attending 5 schools using the self-reported Adolescent Peer Relations questionnaire to assess bullying victimization as well as socio-demographic characteristics. Prevalence rates were generated using a generalized linear model (GLM) customized with a log link and a Poisson distribution for a common binary outcome.RESULTSIn the univariable analysis, 85.7% (n=462) reported experiencing any bullying victimization. Of those who had depression, 93.5% (n=220) had experienced bullying victimization. The difference in prevalence rates between those who were depressed and those who weren’t was statistically significant in the multivariable analysis (adjusted prevalence rate, aPR=1.33; 95%CI=1.05-1.68, p=0.033). Boys were more likely to experience physical victimization compared to girls (aPR=1.27; 95%CI=1.02-1.58, p=0.031).CONCLUSIONThe prevalence of bullying victimization is quite high, and the presence of depression and sex are significant factors associated with the risk of bullying victimization. Anti-bullying interventions in secondary schools should include a component of depression screening and treatment.

Coping with schooling bullying using the "bucket-filling' metaphor as a management strategy

Background: Childhood bullying is a widespread global public health problem that is associated with several adverse long-term physical and mental health problems. The present case report describes the successful implementation of an intervention that focused on improving the socio-emotional skills of a victimized child. Clinical Description: SP, an 8-year-old foster boy was being bullied by his peers at school. This led to him appearing distracted, easily frustrated, scholastic deterioration, and refusal to go to school. He was brought to us by his concerned parents for the evaluation and management. Psychometric testing revealed that the child did not have any intellectual impairment or symptoms of specific learning disability, behavioral, or mood disturbances. Management and Outcome: An intervention that focused on metaphors "bucket filling" (i.e., being kind and considerate), "bucket dippers" (i.e., being mean and hurtful words) was used, the lesson being that one must learn to keep the lid of their own bucket on, so that others cannot empty it. Multiple sessions were taken and assignments given in which the parents were actively involved with the child. After 2 months, the child was better adjusted at school and had made a new friend. The bullying too had declined. Conclusions: Pediatricians need to be able to recognize the symptoms that could indicate bullying. Once recognized, appropriate referrals should be made to competent professionals. Early childhood programs that foster socio-emotional learning using novel strategies are beneficial.

False safety behavior use among Black adults

ABSTRACT Anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to anxiety in predominantly White samples are related to anxiety among Black individuals. Yet, given less mental health service utilization and greater experience of some life stressors, Black persons may be especially at risk for using false safety behaviors (FSB; designed to decrease anxiety in the short term, but are associated with more longer-term mental health problems). We tested whether non-Hispanic/Latin Black persons (n = 133) reported greater FSB use than non-Hispanic/Latin White participants (n = 844) as well as whether FSB use was related to more mental health problems among Black participants. Data were collected online among undergraduates. Black participants did endorse more frequent FSB use, especially FSB-Avoidance and FSB-Body Sensations. Results indicate that among Black participants, FSB use was related to more anxiety, depression, and suicidal thoughts and behaviors. FSB may be an important behavioral vulnerability factor related to anxiety and associated mental health problems among Black young adults.

The development of supported mental health accommodation and community psychiatric nursing in Oxfordshire.

Overcrowding in British mental hospitals was a major service and political concern when the NHS was introduced in 1948. From 1959, a number of projects were initiated locally in Oxfordshire, based from Littlemore Hospital Oxford, to provide alternative accommodation, primarily for long-stay residents. Two NHS hostels were opened and a network of group homes was developed from 1963. These were administered through the hospital League of Friends and supported by the community psychiatric nursing service led by Helmut Leopoldt. From 1977 a separate local charity, Oxfordshire Mind, also provided supported housing for younger patients. These developments can be seen as an early local case study of the provision of non-hospital (supported) accommodation and other forms of support for people with long-term mental health problems.

Associations between dimensions of mental health literacy and adolescent help-seeking intentions.

The majority of long-term mental health problems begin during adolescence. Low mental health literacy (MHL) may impede help-seeking for these problems. Although MHL is a multidimensional construct and adolescent help-seeking can be through formal and informal means, little is known about how dimensions of MHL influence these help-seeking intentions. This study examines associations between dimensions of MHL and formal and informal help-seeking intentions among adolescents. It also investigates whether informal help-seeking mediates the association between dimensions of MHL and formal help-seeking, and whether these associations are moderated by gender. A cross-sectional survey including measures of MHL, and help-seeking intentions was distributed to participants in 10 schools (12-17 years) across Scotland (n=734). Data were analysed using Confirmatory Factor Analyses (CFA) and Structural Equation Modelling (SEM). Confirmatory Factor Analyses identified two distinct dimensions of MHL: ability to identify a mental health problem, and knowledge of treatment efficacy. Only knowledge of treatment efficacy was associated with increased intention to seek formal and informal help. Ability to identify a mental health problem was negatively associated with both forms of help-seeking intentions. Informal help-seeking mediated the association between both forms of MHL and formal help-seeking. Gender did not moderate the associations between MHL and help-seeking. Care should be taken when providing MHL interventions to ensure that adaptive forms of MHL are promoted. Future research should investigate possible mechanisms by which discrete forms of MHL influence adolescent help-seeking as well as investigating other potential moderators of MHL and help-seeking, such as stigma.

Maternal and paternal anxiety during pregnancy: Comparing the effects on behavioral problems in offspring.

Prenatal maternal anxiety has been associated with both short and long-term mental health problems in the child. The current study aims to examine the association between maternal and paternal prenatal anxiety and behaviour problems in the child at 1.5 and 5 years, using three different approaches; (1) adjusting for covariates, (2) using fathers’ anxiety during pregnancy as a negative control, and (3) using a sibling-comparison design, controlling for unmeasured family factors. We used data from the Norwegian Mother, Father and Child Cohort Study (MoBa) is used. MoBa is a cohort consisting of about 114 000 pregnancies (about 34000 siblings) recruited from 1999 to 2008. Self-reported measures on maternal anxiety were obtained twice in pregnancy and 6 months after birth, while paternal anxiety was reported prenatally at 17th weeks of gestation. Maternal reports on child behaviour problems were obtained at 1.5 and 5 years of age. Results suggests that prenatal exposure to maternal anxiety was associated with behaviour problems at 1.5 years: adjusted beta (β) = 0.13 (CI = 0.12, 0.15), and at 5 years: β = 0.11 (CI = 0.09, 0.14). However, paternal anxiety was also associated with behaviour problems at 1.5 years: β = 0.03 (CI = 0.01–0.03) and at 5 years β = 0.03 (CI = 0.02, 0.03). These associations were attenuated in the sibling comparison analyses: β = -0.02 (CI = -0.02–0.05) at 1.5 years and β = -0.05 (CI = -0.10, 0.02) at 5 years. In conclusions, the sibling analyses are not consistent with a direct effect of prenatal maternal anxiety on child behaviour problems. It is more likely that genetic or shared family environment explain this association.