Psychological Risk Factors Research Articles

Coping with COVID: risk and resilience factors for mental health in a German representative panel study.

The coronavirus disease 2019 (COVID-19) pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare. In a stratified random sample of the German household population (n = 6684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors assessed between 2015 and 2020 with changes in psychological distress [(PD; measured via Patient Health Questionnaire for Depression and Anxiety (PHQ-4)] from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting. PHQ-4 scores in 2020 (M = 2.45) and 2021 (M = 2.21) were elevated compared to 2019 (M = 1.79). Several risk factors (catastrophizing, neuroticism, and asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, and optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes. We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. A comparison of pre-pandemic data stresses the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.

Prevalence of Postpartum Depression, Associated Factors, Social Support, and Professional Assistance: A Cross-Sectional Study in Port Said, Egypt

INTRODUCTIONPostpartum depression is a mental illness that affects post-childbirth mothers. It is associated with psychological and social risk factors such as negative childhood experiences and pregnancy and childbirth problems. Postpartum depression has not been a focus of concern in Egypt. Therefore, this study aimed to identify the prevalence of postpartum depression, its associated factors, social support, and professional assistance in Port Said, Egypt.METHODOLOGYA random sampling strategy was used to select 540 women ten weeks postpartum. Data were collected using a questionnaire during an interview to identify potential risk factors for postpartum depression. The modified Arabic version of the Edinburgh Postpartum Depression Scale was used to assess symptoms of postpartum depression which is a multidimensional measure of social communication. Statistical analysis was completed using SPSS 25.0. software.RESULTSIt was found that 24.4% of women were at risk for postpartum depression. Social support from family and friends was significantly associated with mitigation of postpartum depression.CONCLUSIONThis study affirmed postpartum depression was a common health problem among 540 women who gave birth in Port Said, Egypt. Early detection and efficient screening methods to detect postpartum depression should be applied, especially in areas with a high risk for this condition. Early detection may prevent complications for mothers, babies, and families.

The Impact of COVID-19 Pandemic On Malaysian Police Officers Mental Health: Depression, Anxiety and Stress

PurposeCoronavirus disease (COVID-19) outbreak has causes life-changing impacts such as new environmental policies, slowdown of world economy and impact on global health and society. Police officers are among the front liners who continue to bravely fight this pandemic. As the frontline in managing the COVID-19 pandemic, police officers are at high risk for many forms of psychological problems which includes anxiety and depression. It is reported that a total of 60 officers from the New York Police Department died from suicide due to mental health disturbance and approximately 95 police officers in China died on the frontline of fighting this outbreak. Thus, it is important to provide appropriate mental health services and to be able to do such, there is the need to understand the psychological risk factors and their subsequent needs during pandemic. The main purpose of this study is to identify the impact of COVID-19 pandemic to mental health of Malaysian police officers.Methods & MaterialsPolice Stress Questionnaires (PSQ) was used to measure the police-specific stressors related with COVID-19. Meanwhile, Depression Anxiety Stress Scale (DASS-21) questionnaires use to determine the prevalence of occupational stress among police officers.ResultsIt is found that the highest percentage reported of 41.1% moderate depression, 45% of moderate anxiety and 31.8% moderate stress among the respondents. Lack of resources, unequal sharing of work responsibilities, inadequate equipment and high risk to COVID-19 infection are associated with depression, anxiety and stress among police officers. There is significant correlation between COVID-19 stressors and level of depression, anxiety and stress among the police officers with direct correlation.ConclusionMajority of the police officers suffer moderate to severe depression, anxiety and stress during COVID-19 pandemic. Identified stressors from the study help to develop best practices and offers recommendations for policing when handling pandemic in future.

Quality of Life and Job Loss during the COVID-19 Pandemic: Mediation by Hopelessness and Moderation by Trait Emotional Intelligence.

This study contributes to the knowledge on the effects of the COVID-19 pandemic by examining a moderated mediation model in which the impact of job loss over quality of life (QoL) is mediated by hopelessness and moderated by trait emotional intelligence (trait EI). Data were collected from a large nationally representative Italian sample of adult workers (N = 1610), who completed a series of anonymous online questionnaires. Total, direct and indirect effects were estimated through bootstrapped mediated moderation analyses providing 95% bias corrected bootstrap confidence intervals. After controlling for the effects of gender and age range, job loss was found to be negatively associated with QoL, and hopelessness partially mediated such relationship. These relationships were in turn moderated by trait EI. Our study suggests that trait EI levels act as protective factor for a good QoL, mitigating the impact of both job loss and hopelessness over QoL levels during the COVID-19 pandemic. Identifying psychological protective and/or risk factors for a better QoL is crucial for the development of interventions aimed at reducing the emotional impact of the pandemic and of its negative real-life consequences.

Classifying Conduct Disorder Using a Biopsychosocial Model and Machine Learning Method

BackgroundConduct disorder (CD) is a common syndrome with far-reaching effects. Risk factors for the development of CD span social, psychological, and biological domains. Researchers note that predictive models of CD are limited if the focus is on a single risk factor or even a single domain. Machine learning methods are optimized for the extraction of trends across multidomain data but have yet to be implemented in predicting the development of CD. MethodsSocial (e.g., family, income), psychological (e.g., psychiatric, neuropsychological), and biological (e.g., resting-state graph metrics) risk factors were measured using data from the baseline visit of the Adolescent Brain Cognitive Development Study when youth were 9 to 10 years old (N = 2368). Applying a feed-forward neural network machine learning method, risk factors were used to predict CD diagnoses 2 years later. ResultsA model with factors that included social, psychological, and biological domains outperformed models representing factors within any single domain, predicting the presence of a CD diagnosis with 91.18% accuracy. Within each domain, certain factors stood out in terms of their relationship to CD (social: lower parental monitoring, more aggression in the household, lower income; psychological: greater attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms, worse crystallized cognition and card sorting performance; biological: disruptions in the topology of subcortical and frontoparietal networks). ConclusionsThe development of an accurate, sensitive, and specific predictive model of CD has the potential to aid in prevention and intervention efforts. Key risk factors for CD appear best characterized as reflecting unpredictable, impulsive, deprived, and emotional external and internal contexts.

Psychological well-being, risk factors, and coping strategies with social isolation and new challenges in times of adversity caused by the COVID-19 pandemic

ObjectiveCOVID-19 triggers anxiety and fear due to several reasons, and thus, dealing with it requires prolonged coping mechanisms. When the number of infections soared, to slow the spread, many governments decided to close universities and dormitories and move teaching to online platforms. The majority of the university students decided to move back home to their parents changing their social lives. Here, we aimed to point to risk, as well as protective factors, and understand the influence of these factors on both physical and psychological indicators of well-being. Further, to discover how university students cope with maintaining their social lives during the COVID-19 pandemic. MethodWe collected online survey data from multiple university sources. Participants (N = 605) completed measures of emotion regulation strategies, knowledge on the disease, contamination fear, perceived social support, worrying and intolerance of uncertainty, quality of sleep, well-being, emotional stability, anxiety, and depression. ResultsOur results showed that the most prominent risk and protective factors that were most strongly associated with the indicators of well-being were rumination, catastrophizing, positive refocusing, and social support from family; respectively. ConclusionThese results have implications for professionals working with and helping (e.g., as counselors) people during the challenges of an emergency.

Prevention of eating disorders: 2021 in review

ABSTRACT This review of 19 prevention-related publications in Eating Disorders during 2021 is framed by four models: (1) Mental Health Intervention Spectrum: health promotion → types of prevention → case identification/referral → treatment; (2) the prevention cycle: rationale and theory, shaped by critical reviews → clarifying risk and protective factors → program innovation and feasibility studies → efficacy and effectiveness research → program dissemination; (3) links between disordered eating (DE) and eating disorders (EDs); and (4) Kraemer and Jacobi’s criteria for variable, causal risk factors (RFs). Twelve articles demonstrated the strengths and limitations of cross-sectional investigations of RFs for DE and EDs: five explored the role of trauma in activating genetic and psychological RFs (e.g., anxiety and experiential avoidance), while five suggest other variables meriting further evaluation: ergogenic supplement use, “feeling fat,” internalized weight bias, food insecurity, and compulsive exercising. One article presents a pilot program that reduced risk factors in a high-risk group: professional ballerinas. Implications of the absence of efficacy, effectiveness, dissemination, and advocacy studies, along with the need to develop tailored programs for various high-risk groups, are discussed.

Non suicidal self injury and suicidal behavior among adolescents: co-occurrence and associated risk factors

BackgroundNon-suicidal self-injury (NSSI) and suicidal behavior (SB) are the major public health problems in adolescents. Despite the increased focus on these phenomena, there exist no reliable data in Nepal. This study aimed to determine the prevalence of NSSI and SB among adolescents. Furthermore the study identified the relationship between these two behaviors and assessed demographic, behavioral, and psychological risk factors of NSSI and SB in Nepalese adolescents in a representative sample of the general population.MethodsThe study was conducted among 730 adolescents studying in grade 9 to 12 of public and private schools of Pokhara Metropolitan city, Nepal. Data were collected through self administered standard tools- Functional Assessment of Self Mutilation (FASM) tool, Suicidal Behaviors Questionnaire-Revised (SBQ-R), Rosenberg self-esteem scale (RSES) and Beck Depression Inventory (BDI). Descriptive statistical measures such as frequency, percentage, mean, standard deviation, range were used to assess demographic characteristics and adolescent’s behavior regarding NSSI and suicide. For inferential analysis chi-square and one way ANOVA test was used. Furthermore, to determine the predictors of NSSI and SB, multiple logistic regression analysis was used.ResultsRegarding behavioral characteristics, nearly half of the sample 327 (44.8%) reported a history of NSSI in past 1 year. Furthermore, 25.8% (n = 188) of the overall sample engaged in minor NSSI only and 3.42% (n = 25) engaged in at least one act of moderate/severe NSSI. The mean number of type of NSSI performed was 2.63 ± 1.71. The most common type of NSSI method used were picking at wound (27.3%), biting self (20.3%), pulling hair out (11.8%), cutting self (11.1%). Boys (52.6%) were more likely to be engaged in NSSI than girls (47.4%) (χ2 = 10.298, p = 0.002). Furthermore, among 730 adolescents who completed the SBQ-R questionnaire, 131 (17.9%) had suicidal behaviors (SB) (as defined by SBQ-R a total score ≥ 7). Regarding sex differences female were significantly higher in life time prevalence of suicidal behavior than male (χ2 = 30.26, p = 0.001). Simple Chi-square tests indicated that NSSI was significantly associated with SB (χ2 = 58.16, P < .001). Logistic regressions identified the four significant predictors of NSSI behavior: male, low-level of self-esteem (SE), moderate to severe form of depression and SB. Similarly, significant predictors of SB were: female, low-level of SE, moderate to severe form of depression and NSSI behavior.ConclusionThe prevalence of both NSSI and SB is high in adolescents. Despite the differences between NSSI and SB a significant number of adolescents reported a history of both behaviors. Lower level of SE and moderate to severe depression were the significant predictors of both NSSI and SB. Furthermore, male and adolescents with the history of SB were at risk of NSSI behavior whereas female sex and adolescents with the history of NSSI were at risk of SB.

Effects of treadmill slip and trip perturbation-based balance training on falls in community-dwelling older adults (STABILITY): study protocol for a randomised controlled trial

IntroductionFalls among older adults are most frequently caused by slips and trips and can have devastating consequences. Perturbation-based balance training (PBT) have recently shown promising fall preventive effects after even...

Sleep disturbances predict active suicidal ideation the next day: an ecological momentary assessment study

BackgroundSleep disturbances are an underestimated risk factor for suicidal ideation and behavior. Previous research provided preliminary support of a temporal relationship between sleep disturbances and suicidal ideation. The present study therefore sought to investigate the prospective association between sleep disturbances, passive and active suicidal ideation, and further psychological risk factors, such as state impulsivity and depression.MethodsSeventy-three psychiatric inpatients (71% female) with unipolar depressive disorder and current or lifetime suicidal ideation took part in an ecological momentary assessment (EMA). Participants filled out a baseline assessment and data were collected via smartphones over a 6-days period. Multilevel analyses with sleep disturbance as predictor for active and passive suicidal ideation, state impulsivity, and depression were carried out.ResultsPatients with sleep disturbance experienced more active suicidal ideation, but no passive suicidal ideation, the following day. Of the four state impulsivity items, one item was significantly associated with sleep disturbance. Sleep disturbance had no effect on next-day depression. Limiting factors are the small and homogeneous sample along with the rather short observation period in an inpatient setting.ConclusionsThe micro-longitudinal study provides preliminary support for sleep disturbance as a proximal risk factor for next-day active suicidal ideation. Clinically, results indicate to consider the evaluation and treatment of sleep disturbances for an improved risk assessment and prevention of suicide.

Psychological risk factors that characterize acute stress disorder and trajectories of posttraumatic stress disorder after injury: a study using latent class analysis

ABSTRACT Background The course and different characteristics of acute and posttraumatic stress disorder (ASD, PTSD) in trauma populations are unclear. Objective The aims were to identify longitudinal trajectories of PTSD, to establish a risk profile for ASD and PTSD based on patients’ sociodemographic, clinical, and psychological characteristics, and to study the effect of ASD and dissociation on PTSD during 12 months after trauma. Method Patients completed questionnaires after inclusion and at 3, 6, 9, and 12 months afterwards. Trajectories were identified using repeated measures latent class analysis (RMLCA). The risk profile was based on a ranking of importance of each characteristic using Cohen’s d effect sizes and odds ratios. The impact of ASD and dissociation on PTSD was examined using logistic regression analyses. Results Altogether, 267 patients were included. The mean age was 54.0 (SD = 16.1) and 62% were men. The prevalence rate of ASD was approximately 21.7% at baseline, and 36.1% of trauma patients exhibited PTSD at 12 months after injury. Five trajectories were identified: (1) no PTSD symptoms, (2) mild, (3) moderate, (4) subclinical, and (5) severe PTSD symptoms. These trajectories seemed to remain stable over time. Compared with patients in other trajectories, patients with ASD and (subclinical) PTSD were younger and scored higher on anxiety, depressive symptoms, neuroticism, and trait anxiety. Regarding dissociation symptoms, inability to recall memories about the event was significantly more present than an altered sense of reality, (105 (40.7%) versus 56 (21.7%), p = .031), although that symptom had the strongest likelihood for PTSD. Patients with dissociation were significantly at risk for PTSD than patients without dissociation (OR = 4.82; 95%CI: 1.91–12.25). Conclusions Psychological factors characterized ASD and trajectories of PTSD during 12 months post-trauma. Healthcare providers who are aware of these findings could early identify patients at risk for ASD and PTSD and refer them for patient-centred interventions.

Psychological risk factors for the occurrence of frozen shoulder after rotator cuff repair

IntroductionFrozen shoulder is a dreaded complication after rotator cuff repair. HypothesisThere are psychological determinants for this complication. Materials and methodsWe prospectively included 77 consecutive patients who underwent arthroscopic rotator cuff repair between May 2018 and April 2019. Along with a functional evaluation, we determined the Constant score, anxiety and depression levels based on the HADS, and kinesiophobia based on the Tampa Scale preoperatively and 6months after the surgery. ResultsAt the 6-month follow-up, 8 patients had been diagnosed with frozen shoulder (group A), 65 patients had satisfactory joint range of motion (group B) and 4 were lost to follow-up. In the frozen shoulder group, the preoperative anxiety rate was significantly higher than in group B (50% versus 17%, p=0.04). Furthermore, there were significantly more women (p=0.028) and more patients with an occupational disease in group A (75% versus 18%, p=0.027). At 6months postoperative, the Constant score was 55 in the group with a frozen shoulder versus 72 in group B (p=0.004). Neither depression nor kinesiophobia were risk factors for the development of frozen shoulder after rotator cuff repair. ConclusionPreoperative anxiety, the female sex and occupational disease are all risk factors for the occurrence of frozen shoulder after rotator cuff repair. Knowing these predisposing factors will help us better manage at-risk patients. Level of evidenceIII, prospective study.

Disentangling the diversity of profiles of adaptation in youth during COVID-19

Background: The COVID-19 outbreak has major psychosocial consequences on the global population and specialists report that youth may be significantly impacted. Adolescents and young adults, for whom social life is an important protective factor, had to face a new isolation caused by social distancing and home schooling. This study aims to explore youth's profiles of adaptation to COVID-19 pandemic in the province of Quebec, Canada, and the risk factors and strengths associated with each profile.Methods: A sample of 4936 youth living in Quebec were recruited on social media and filled out an online survey during the lockdown of the first wave of COVID-19. They completed measures of psychological distress, positive adaptation (well-being, resilience), risk factors (alexithymia and emotional dysregulation), COVID-related worries and fear of contamination and COVID-related post-traumatic stress disorder (PTSD).Results: The results of the latent class analysis showed four patterns of adjustment. The Resilient group (36.6% of the sample) showed the highest probability of a positive adaptation. The High distress class (29.5%) reported clinical distress, low to moderate symptoms of PTSD and fear of contamination and no significant well-being. The Moderate symptoms class (17.55%) showed moderate levels of distress and COVID-related symptoms, with half of the group still showing significant well-being. The Traumatized class (16.35%) reported the worst adaptation. Correlates significantly differentiated profiles.Limitations: The study relied on a convenience sample and a cross-sectional design.Conclusion: Disentangling the diversity of adaptation profiles may orient more adapted resources for youth in need during this unprecedented crisis.

ОСНОВЫ ПЕРСОНАЛИЗИРОВАННОГО ПОДХОДА ПРИ МЕДИКО-ПСИХОЛОГИЧЕСКОМ СОПРОВОЖДЕНИИ КАРДИОХИРУРГИЧЕСКИХ ПАЦИЕНТОВ

The concept of a personalized approach is becoming more and more popular in modern medicine. Today it is often understood as a multidisciplinary approach designed to improve therapeutic options, as well as help diagnose diseases at an early stage. In a cardiac surgery clinic, such an approach can take into account not only biological, but also psychological risk factors for the disease, especially its history, clinical condition, mental and psychological status to create an individual route within the framework of medical and psychological support for the patient at the stages of treatment and rehabilitation. The aim of the work was to develop, based on the analysis of the literature and the authors' own work experience, the organizational and psychological foundations for the implementation of a personalized approach in medical and psychological support of cardiac patients. The fundamental principles of support in the work include the following: the principle of accessibility, the principle of openness, the principle of continuity, the principle of complexity, the principle of integrativity, the principle of differentiation, the principle of variability, the principle of participativeness, the principle of awareness, the principle of prevention. In the process of medical and psychological support of cardiac surgical patients within the framework of a personalized approach, the most optimal was the identification of the following clinical stages, different in duration and content, corresponding to the periods of outpatient and inpatient treatment and rehabilitation of patients: preoperative outpatient, preoperative inpatient, early postoperative, postoperative inpatient, postoperative rehabilitation and rehabilitation outpatient stages. For each of the clinical stages of medical and psychological support, a differentiation of goals, objectives, duration and expected results of the impact was carried out, which makes it possible to personalize the programs for accompanying a cardiac patient and individualize the route for each patient, taking into account the specificity and relevance of the influence of biologi cal, psychological and social factors.

Does group-based cognitive therapy improve functional ability, pain, catastrophic thoughts and quality of life in patients with persistent low back pain and psychological risk factors? A randomised controlled trial in a secondary care setting

Objective To investigate the effects of a group-based cognitive behavioural intervention for patients with persistent low back pain (LBP) and psychological risk factors referred to secondary care. Design A randomised controlled trial. Setting Silkeborg Regional Hospital, Denmark. Subjects A total of 136 participants with chronic LBP and psychological risk factors. Interventions Participants were randomised to the standard care group, including examination by a rheumatologist and/or a physiotherapist, or the intervention group, including standard care plus a multidisciplinary group-based pain management programme. Main measures Patient-reported outcomes were collected at baseline and after 6 and 12 months. The primary outcome was disability (Roland Morris Disability Questionnaire). Secondary outcomes included low back pain intensity, pain catastrophising, health-related quality of life, and sick leave. Results Among 136 participants, 68 (mean age: 41.7 years (SD 11.8)) were randomised to standard care and 68 (mean age: 46.0 years (SD 10.8)) were randomised to the intervention group. Except for age, baseline characteristics were comparable between groups. 12-month follow-up was completed by 92.6% in the intervention group and 80.9% in the standard care group. Both groups achieved significant improvements on disability, with a reduction of −4.8 points (SD 6.1) in the intervention group compared to −3.7 points (SD 5.2), resulting in an insignificant difference between groups. No significant differences were found in the secondary outcomes. Conclusion A group-based pain management programme was no more effective than standard care for patients with persistent LBP and psychological risk factors.

Network modeling of anxiety and psychological characteristics on suicidal behavior: Cross-sectional study

BackgroundSuicide is influenced by complex interactions among various psychopathological features. We aimed to examine the relationship between suicide risk and psychological risk factors such as defense mechanisms, personality, and anxiety. MethodsWe established a psychiatric database by utilizing the Observational Medical Outcomes Partnership Common Data Model. We conducted a 1:1 propensity score matching with age, sex, and depression severity, and identified a sample (n = 258) with two groups: those with suicidal behavior and those with non-suicidal behavior. Using principal component analysis, we extracted nine psychological scales and applied network analysis to compare relationships among psychological factors between the two groups. ResultsPatients with non-suicidal behaviors showed associations between trait anxiety and defense mechanisms, while those with suicidal behaviors did not. For patients with suicidal ideation there was an association between somatization and trait anxiety. Patients with suicide attempts showed associations between paranoia and dissociation connected to trait anxiety. LimitationsLongitudinal research is required to fully observe transitions from suicidal ideation to attempts and recurrent suicidal events. In addition, these networks may not generalize suicidal behaviors because the group participants are not homogeneous. Lastly, data from self-report questionnaires limits the reliability of responses. ConclusionsWe presented important new insights on suicidal behavior by estimating psychological networks. Patients with non-suicidal behavior may exhibit discrete relationships between defense mechanisms and anxiety, compared to those with suicidal behavior. Patients with suicidal ideation and suicide attempts may show distinct associations between anxiety and psychopathological features.

The Importance of Suicide Risk Formulation in Schizophrenia.

Suicide is a cause of early mortality in nearly 5% of patients with schizophrenia, and 25–50% of patients with schizophrenia attempt suicide in their lifetime. Evidence points to numerous individual, clinical, social, and psychological risk factors for suicide in patients with schizophrenia. Although recognizing suicidal risk factors in schizophrenia is extremely important in suicidal risk assessment, we have recently witnessed a change in suicide risk management that shifts the focus from suicide risk assessment to suicide risk formulation. Suicide risk formulation is dependent on the data gathered in the suicide risk assessment and assigns a level of suicide risk that is indispensable for the choice of treatment and the management of patients with a high suicidal risk. In this article, we extend the suicide risk formulation model to patients with schizophrenia. Suicide risk formulation results from four different areas that help clinicians collect as much information as possible for the management of suicidal risk. The four distinct judgments comprise risk status (the risk relating to the specific group to which the patient belongs), risk state (the risk for the person compared with his baseline or another reference point in the course of his life), available resources (on whom the person can count during a crisis) and foreseeable events (which can exacerbate the crisis). In schizophrenia, the suicide risk formulation model allows the clinician to evaluate in depth the clinical context of the patient, the patient's own history and patient-specific opportunities for better choosing and applying suicide prevention strategies.

Prevalence and associated psychological risk factors of postpartum depression: a cross-sectional study

This cross-sectional study aimed to evaluate the prevalence of postpartum depression and the associated risk factors in a sample of Italian women at three months after delivery. Eighty women were screened by completing the Edinburgh Postnatal Depression Scale (EPDS). Women with a score ≥10 were evaluated as positive and other variables were detected through the administration of the Postpartum Depression Predictors Inventory. The prevalence of postpartum depression in the sample was 11.25% (EPDS score >10). A statistically significant relationship was found between the predisposition to postnatal depression and various risk factors such as prenatal depression, stressful life experiences marital problems. Furthermore, strong emotional and instrumental support from the partner and a good economic status can represent protective factors. It is essential to promote an integrated approach to postpartum affective disorders in which psychosocial risk factors are taken into account, and adequate screening programs are implemented. Impact Statement What is already known on this subject? Pregnancy can cause emotional stress for women with consequent development, in some cases, of mood disorders such as postpartum depression. What do the results of this study add? According to this study, women suffering from postpartum depression showed a significant tendency to anxiety and depression, low perceived support from the partner, and low socio-economic status. What are the implications of these findings for clinical practice and/or further research? It would be desirable to promote an integrated approach to postpartum affective disorders in which psychosocial risk factors are taken into account and adequate screening programs are implemented.

Reaching 80 Years of Age: Clinical, Behavioral, and Psychosocial Related Risk Factors in a Large Cohort of Israeli Working Men.

The objective of this study was to estimate the probability of long-term overall survival based on total number of risk factors (RF). We also sought to examine the role of midlife clinical, behavioral, and psychosocial predictors of longevity in a large cohort of Israeli men. This study was based on the Israeli Ischemic Heart Disease (IIHD) cohort that included over 10,000 men who were followed up for mortality over more than four decades. During the 43 years of follow-up, 4634 (46.1%) men survived to 80 years of age or older. We considered cigarette smoking, diabetes mellitus, high systolic blood pressure, hypercholesterolemia, low socioeconomic status, and serious family problems as RF at ages 40–65. Cox proportional hazards regression models, with age as the time scale, were constructed to estimate the hazard ratios (HRs) for failure to survive 80 years of age. Compared with men free of all the above RF, those with one identified RF (HR = 1.58, 95% CI: 1.42–1.75) and counterparts with two identified RF (HR = 2.18, 95% CI: 1.96–2.43) were at a significantly greater risk of death before 80. Additional RF further increased the risk of early mortality (HR = 3.62, 95% CI: 1.50–8.73 for men with 5 RF). The results suggest a role of physiological, behavioral, and psychological risk factors at midlife in predicting longevity.

Differentiating Categories of Violent Adolescent Offending and the Associated Risks in Police and Youth Offending Service Records.

Historical risk assessment forms for a sample of 173 males with a history of violent offending and under supervision by Merseyside Youth Offending Services (YOS) were investigated. Subsequent arrest records were scrutinised in order to obtain a better understanding of the relationship of social and psychological risk factors to offending behavior. The mean age of the sample at the point of contact with YOS was 16.01 (SD = 1.37) with a range between 12 and 18 years. Assault was associated with solo expressive offending, a history of domestic violence, low school attendance and an inability to control impulsivity and aggression. Robbery was associated instrumental and escalated violent offending, psychological disorders, and deviant groups, including family criminal involvement. Risk assessments by professionals and the young people indicated that substance misuse co-occurred with robbery. The findings suggest that solo offenders commit the majority of violent offences and that targeted interventions should distinguish between expressive and instrumental offending.