Risk For Mental Health Issues Research Articles

Mindfulness-based stress reduction for elementary school teachers: a randomized controlled trial

Educators frequently grapple with elevated levels of job-related stress, heightening the risk of mental health issues. Although Mindfulness-Based Stress Reduction (MBSR) has demonstrated effectiveness in reducing stress among the general populace, its implementation among educators, especially in non-United States settings, has received limited exploration. This pre-registered randomized-controlled trial investigates the effectiveness of the standard MBSR in reducing perceived stress among Dutch elementary school teachers. Additionally, it examines the impact of MBSR on mindfulness skills, emotion regulation, and self-compassion as secondary proximal outcomes, along with exploring its influence on teacher self-efficacy, perceived pupil-teacher relationships, and classroom climate quality as secondary distal outcomes. Involving 146 teachers randomly assigned to either the intervention (n = 72) or waitlist-control condition (n = 74), assessments were conducted pre- and post-intervention or control period, with a 3-month follow-up. Participants in the intervention reported significantly lower perceived stress compared to the control group, demonstrating a substantial effect size at post-treatment (d = −0.84) and a moderate effect at follow-up (d = −0.69). MBSR not only yielded improvements in personal well-being but also positively impacted teacher self-efficacy and classroom climate quality at both post-treatment and follow-up. These positive outcomes aligned with enhancements in mindfulness skills, emotion regulation, and self-compassion. However, no significant effects were observed on the pupil-teacher relationship. Exploratory analyses revealed no moderation effects based on past or present psychological problems, school weight/pupil population, years of experience, or age on perceived stress at post-measurement. Furthermore, the study examined the potential influence of COVID-19 on the results, concluding that the pandemic had no discernible impact. These findings advocate for the widespread adoption of the standard MBSR program as a means of enhancing the well-being of elementary school teachers.

Associations between breakfast skipping and outcomes in neuropsychiatric disorders, cognitive performance, and frailty: a Mendelian randomization study

BackgroundPrior studies have identified a correlation between breakfast skipping and a heightened risk of mental health issues. This investigation aimed to employ a Two-Sample Mendelian Randomization (MR) approach to explore the potential causal links between breakfast skipping and various psychiatric, neurological disorders, cognitive performance, and frailty.MethodsUtilizing data from genome-wide association studies within European demographics, this research scrutinized the association between breakfast habits and several neuropsychiatric conditions and physical health outcomes, including Alzheimer’s disease (AD), Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BD), Major Depressive Disorder (MDD), Narcolepsy, Insomnia, cognitive performance, and frailty. In this MR analysis, the Inverse Variance Weighted (IVW) method was primarily utilized for evaluation. Outcomes were reported as Odds Ratios (OR) and regression coefficients (β), and underwent validation through False Discovery Rate (FDR) corrections, thereby offering a rigorous evaluation of the effects of breakfast habits on both mental and physical health dimensions.ResultsFindings demonstrate a significant causal link between skipping breakfast and an increased risk of ADHD (OR = 2.74, 95%CI: 1.54–4.88, PFDR = 0.003) and MDD (OR = 1.7, 95%CI: 1.22–2.37, PFDR = 0.005). Conversely, no substantial causal associations were identified between breakfast skipping and AD, BD, narcolepsy, or insomnia (PFDR > 0.05). Moreover, a notable causal relationship was established between skipping breakfast and a reduction in cognitive performance (β = -0.16, 95%CI: -0.29–0.04, PFDR = 0.024) and an increase in frailty (β = 0.29, 95%CI: 0.12–0.45, PFDR = 0.003).ConclusionThe MR analysis reveals that skipping breakfast is associated with an increased risk of ADHD, MDD, decreased cognitive performance, and greater frailty, while showing no associations were found with AD, BD, narcolepsy, or insomnia. These findings warrant further investigation into the underlying mechanisms and emphasize the importance of regular breakfast consumption for mental and physical well-being.

The relationship between chronotype and suicidal attempt in patients with schizophrenia

IntroductionIndividuals with schizophrenia are known to be at an increased risk of suicidal behavior (Sher & Kahn, 2019). However, the relationship between chronotype, which refers to an individual’s preference for sleep-wake patterns, and suicidal attempts in schizophrenia patients remains an area of interest and investigation.The relationship between chronotype and suicidal attempts in schizophrenia patients has not been extensively studied. However, research in other populations has shown that individuals with evening chronotypes, also known as “night owls,” may be at a higher risk of mental health issues, including depression and suicidal ideation (Verma et al., 2016). It is plausible to hypothesize that individuals with schizophrenia who have evening chronotypes may also be at an increased risk of suicidal attempts. Further research is needed to explore this relationship and its potential implications for clinical practice. In conclusion, the relationship between chronotype and suicidal attempts in schizophrenia patients is an area that requires further investigation.Early identification and intervention are crucial in preventing further suicidal attempts in this vulnerable population. Future research should focus on exploring the relationship between chronotype and suicidal attempts in schizophrenia patients to provide a comprehensive understanding of the factors contributing to suicide risk in this population.ObjectivesThis study investigates the relationship between chronotype and suicidal attempts in patients with schizophrenia.MethodsThe study was conducted cross-sectionally using quantitative research methods and using purposive sampling. The personal information form and scales used for data collection in this study, which was planned with patients hospitalized in the psychiatric ward and patients applying to the outpatient clinic, are based on self-report. The personal information form developed by the researcher by reviewing the literature, the Morningist-Evening Scale (SAM), the Suicide Probability Scale, the Suicidal Behavior Scale, the Positive Symptoms Rating Scale (SAPS) and the Negative Symptoms Rating Scale (SANS) were used as data collection tools. Participants signed an informed consent form before the interview.ResultsData extraction is still ongoing in detailed style by principal authors. A description of the studies and the key findings will be presented.ConclusionsReducing the risk of suicide in patients with schizophrenia is of vital importance. Awareness of the risks related to suicide may help reduce mortality rates in schizophrenia patients as in all patients. It is thought that the study’s results will be an important resource in knowing the risks related to suicide and determining the risk factors so that prevention studies can be initiated.Disclosure of InterestNone Declared

Perceived discrimination as a mediator between cultural identity and mental health symptoms among racial/ethnic minority adults in the United States: insights from the Health Information National Trends Survey 6.

This study examined the role of perceived discrimination as a mediator between cultural identity and mental health symptoms among adults from racial/ethnic minority groups in the United States. Data were gathered from the National Cancer Institute's (NCI) Health Information National Trends Survey (HINTS) 6, a nationally representative survey. The mediating role of perceived discrimination was investigated using structural equation modeling (SEM) analysis. The study found significant associations between demographic and lifestyle factors and mental health symptoms. Non-Hispanic Blacks or African Americans and Hispanics were less likely than Non-Hispanic Whites to have mental health symptoms. Individuals between the ages of 35 and 49, 50 to 64, 65 to 74, and 75 and older had lower odds of mental health symptoms. Gender differences revealed that females had a higher risk of mental health issues than males. Socioeconomic factors, such as household income and employment status, played a significant role, with higher household income and employment status being associated with a decreased likelihood of mental health symptoms. The study emphasizes the role of perceived discrimination as a mediator, suggesting that it fully mediated the association between cultural identity and mental health symptoms. These findings highlight the significance of addressing discrimination experiences in fostering the mental health of adults from diverse backgrounds. The findings highlight the need to take racial, ethnic, and socioeconomic inequities, as well as cultural identity and prejudice, into account in mental health research and interventions. The identified risk and protective factors can guide interventions and policies to enhance this population's mental health.

Fatty Acid Amide Hydrolase and Cannabinoid Receptor Type 1 Genes Regulation is Modulated by Social Isolation in Rats.

Social isolation is a state of lack of social connections, involving the modulation of different molecular signalling cascades and associated with high risk of mental health issues. To investigate if and how gene expression is modulated by social experience at the central level, we analyzed the effects of 5weeks of social isolation in rats focusing on endocannabinoid system genes transcription in key brain regions involved in emotional control. We observed selective reduction in mRNA levels for fatty acid amide hydrolase (Faah) and cannabinoid receptor type 1 (Cnr1) genes in the amygdala complex and of Cnr1 in the prefrontal cortex of socially isolated rats when compared to controls, and these changes appear to be partially driven by trimethylation of Lysine 27 and acetylation of Lysine 9 at Histone 3. The alterations of Cnr1 transcriptional regulation result also directly correlated with those of oxytocin receptor gene. We here suggest that to counteract the effects of SI, it is of relevance to restore the endocannabinoid system homeostasis via the use of environmental triggers able to revert those epigenetic mechanisms accounting for the alterations observed.

Daily life affective dynamics as transdiagnostic predictors of mental health symptoms: An ecological momentary assessment study

BackgroundAffective dynamics have been identified as a correlate of a broad span of mental health issues, making them key candidate transdiagnostic factors. However, there remains a lack of knowledge about which aspects of affective dynamics – especially as they manifest in the course of daily life – relate to a general risk for mental health issues versus specific symptoms. MethodsWe leverage an ecological momentary assessment (EMA) study design with four measures per day over a two-week period to explore how negative affect levels, inertia, lability, and reactivity to provocation and stress in the course of daily life relate to mental health symptoms in young adults (n = 256) in the domains of anxiety, depression, psychosis-like symptoms, behaviour problems, suicidality, and substance use. ResultsDynamic structural equation modelling (DSEM) suggested that negative affect levels in daily life were associated with depression, anxiety, indirect and proactive aggression, psychosis, anxiety, and self-injury; negative affective lability was associated with depression, physical aggression, reactive aggression, suicidal ideation, and ADHD symptoms; negative affective inertia was associated with depression, anxiety, physical aggression, and cannabis use; and emotional reactivity to provocation was related to physical aggression. LimitationsThe cross-sectional design, the limited span of mental health issues included, and the convenience nature and small size of the sample are limitations. ConclusionsFindings suggest that a subset of mental health symptoms have shared negative affective dynamics patterns. Longitudinal research is needed to rigorously examine the directionality of the effects underlying the association between affective dynamics and mental health issues.

Physical activity and sedentary behaviors and the impact on college student’s stress, depression, and anxiety

University students are at a significant risk for mental health issues, including stress and depression. Negative mental health among college-aged adults continues to rise, impacting students’ cognitive function, academic performance, social development, and overall well-being. Rather than offering support through medication, physical activity has demonstrated a potential behavioral approach to reduce students’ stress and anxiety. The current study examined the influence of young adults’ physical activity and sedentary behavior levels and their self-reported stress, depression, and psychological well-being. Participants were undergraduate and graduate students recruited from a Midwestern university and a Mid-Southern university. Multiple linear regressions estimated mean differences in participants’ self-reported stress, depression, and psychological well-being based on their physical activity levels and sitting minutes. Moderate levels of physical activity improved participants’ growth psychological well-being (p = .01). Vigorous physical activity had an effect on participants’ relations, purpose, and self-acceptance (p<0.05). Daily sitting minutes significantly affected participants’ stress, perceived stress, depression, and environmental psychological wellness (p<0.05). Results demonstrate how physical activity can be a natural medicine for symptoms of stress and depression. Current outcomes support the development of future programs to prevent and react to mental health via physical activity.

Mental Health Interventions for Migrant Children in China: A Framework Informed by Ecological Systems Theory

As the rural-to-urban migration continues, millions of children accompany their families into urban environments, where they face complex challenges adapting to urban life, resulting in mental health issues. This paper delves into the current academic conversations to dissect the mental health challenges faced by migrant children due to their struggles with social adaptation to provide a more comprehensive understanding of the developmental barriers experienced by migrant children in China. Drawing on Bronfenbrenners ecological systems theory, this paper also advocates for a multilevel intervention framework across four domains: family, school, community, and society. Implementing this comprehensive framework offers migrant children improved adaptation to urban life and a reduced risk of mental health issues. While practical challenges exist, increased attention from social workers, educators, and policymakers, as well as supportive legislation, can enhance the well-being and adaptation of migrant children in Chinas evolving society.

A Proposal for Improving Student-Athletes’ Mental Health Through Leadership Training

Student-athletes face a variety of stressors and are at risk for mental health issues, particularly with “name, image, and likeness” issues creating new pressures and distractions. This article outlines a leadership development program geared toward student-athletes and the enrichment of their mental health. The courricular content described within includes self-development material delivered by faculty in a team context. Early findings indicate that the Positive Leadership Program appears to make impactful improvements in mental health outcomes and can be introduced into sport management curricula.

The Effect of Laughter Therapy on General Health Status, Sleep Quality, and Stress Level of Nursing Students: A Randomized Controlled Trial

Background: University students are at a heightened risk for mental health issues. This study aimed to evaluate the impact of laughter therapy on the mental health, sleep quality, and stress levels of nursing students. Methods: This randomized controlled experimental study was conducted among first- and second-year nursing students at a university in Turkey between February and May 2021. Block randomization was utilized to assign 70 students (35 in the experimental group and 35 in the control group) to the study. The experimental group participated in eight 45-minute online laughter therapy sessions. Data were collected using the Introductory Information Form, General Health Questionnaire-28, Pittsburgh Sleep Quality Index, and Perceived Stress Scale. Mann-Whitney U Test was employed for intergroup comparisons, while the Wilcoxon Signed Rank Test was used for intragroup comparisons. Categorical data were analyzed using the chi-square test. Results: There were no statistically significant differences between the experimental and control groups in the pre-test scores for the Perceived Stress Scale, General Health Questionnaire, and Pittsburgh Sleep Quality Index (p> 0.05). However, post-test scores indicated significant improvements in the experimental group (p<0.001), demonstrating that laughter therapy was effective in enhancing perceived stress, general health status, and sleep quality (r ≅0.50). Conclusion: Laughter therapy has beneficial effects on mental health, sleep quality, and perceived stress. It is recommended that school health nurses integrate laughter therapy into health promotion and protection strategies to increase its utilization.

Mapping the evidence on psychosocial interventions for migrant populations: Descriptive analysis of a living database of randomized studies.

Migrant mental health is a pressing public health issue with wide-ranging implications. Many randomized controlled trials (RCTs) have been conducted in this population to assess the effects of psychosocial interventions. However, the available evidence is characterized by controversy and fragmentation, with studies focusing on different migrant populations, interventions, outcomes, delivery modalities and settings. Aiming to promote systematic reviews of the effectiveness of psychosocial interventions in different migrant groups, we have developed a living database of existing RCTs. The development of the database provides an opportunity to map the existing RCT evidence in this population. A total of 135 studies involving 24,859 participants were included in the living database. The distribution of studies by year of publication aligns with the increasing global migrant population in recent years. Most studies focus primarily on adult participants, with a limited representation of children and adolescents, and a prevalence of female participants, which is consistent with epidemiological data, except for older adults, who are underrepresented in research. Studies predominantly focus on refugees and asylum seekers, likely due to their elevated risk of mental health issues, despite the substantial presence of economic migrants worldwide. While studies mainly involve migrants from the Middle East and East Asia, epidemiological data suggest a broader geographic representation, with migrants coming from Eastern Europe, Latin America and South Asia. The present descriptive analysis of RCTs on mental health and psychosocial interventions for migrant populations provides valuable insights into the existing research landscape. It should be used to inform future research efforts, ensuring that studies are more representative of the global migrant population and more responsive to the mental health needs of migrants in different contexts.

Children Fleeing War-Exploring the Mental Health of Refugee Children Arriving in Israel after the Ukraine 2022 Conflict

BackgroundIn February 2022, Ukraine suffered a devastating assault by Russia, leading to destruction, casualties, and mass displacement. Among those displaced were over 1.5 million children. Forced displacement exposes children to a heightened risk of mental health issues. ObjectiveThis study investigated the prevalence of Post-traumatic stress disorder (PTSD) and other mental health issues among child refugees shortly after their displacement from Ukraine to Israel. It aimed to identify factors influencing PTSD development and explore their associations. MethodsThe study included 59 child refugees who had arrived in Israel after fleeing the war in Ukraine. Parents completed self-report questionnaires to assess their children's mental health. ResultsOnly three children met the DSM diagnostic criteria for PTSD, with higher scores in the negative cognition and re-experiencing clusters. Over half of the children exhibited general mental health problems, with approximately 40 % showing internalizing problems, and 30 % showing externalizing problems. The study also found a significant comorbidity between PTSD symptoms and internalizing problems. Additionally, internalizing problems emerged as the sole significant predictor of PTSD levels when considering factors such as age, gender, economic status, parents' work status, internalizing problems, and externalizing problems. ConclusionsChild refugees frequently experience psychological distress, even if they do not meet the formal diagnostic criteria for PTSD. They often exhibit other distress symptoms, primarily internalizing problems, which can be challenging to detect. A deeper understanding of the challenges faced by refugee children can inform the development of targeted assistance programs and the recruitment and training of personnel in host countries.

Composite healthy lifestyle, socioeconomic deprivation, and mental well-being during the COVID-19 pandemic: a prospective analysis

The adverse psychological and social impacts of COVID-19 pandemic are well characterized, but the role of composite, modifiable lifestyle factors that may interact to mitigate these impacts is not. The effect of socioeconomic deprivation on these lifestyle risks also remains unclear. Based on a nationally representative, longitudinal cohort, we assessed the association between a combination of pre-pandemic lifestyle factors and mental health conditions during pandemic, and the contribution of deprivation to it. Composite lifestyle factors included BMI, smoking status, alcohol consumption, physical activity, sedentary time, sleep duration, and fruit and vegetable intake, with lifestyle scores and lifestyle categories calculated for each participant. Symptoms of depression and anxiety, and personal well-being were assessed by validated scales during the pandemic. Socioeconomic deprivation was characterized by both individual-level (income, wealth, and education) and group-level factors (Index of Multiple Deprivation). Of the 5049 eligible participants (mean [SD] age, 68.1 [10.9] years; 57.2% were female) included in the study, 41.6% followed a favorable lifestyle, 48.9% followed an intermediate lifestyle, and 9.5% followed an unfavorable lifestyle. Compared with favorable lifestyle category, participants in the intermediate and unfavorable lifestyle category were at increased risk of mental health conditions, with the hazard ratio (HR) for trend per increment change towards unfavorable category of 1.17 (95% CI 1.09–1.26) for depression, 1.23 (1.07–1.42) for anxiety, and 1.39 (1.20–1.61) for low well-being. A significant trend of lower risk for mental health conditions with increasing number of healthy lifestyle factors was observed (P < 0.001 for trend). There were no significant interactions between lifestyle factors and socioeconomic deprivation for any of the outcomes, with similar HRs for trend per one increment change in lifestyle category observed in each deprivation group. Compared with those in the least deprived group with favorable lifestyle, participants in the most deprived group adherent to unfavorable lifestyle had the highest risk of mental health outcomes. These results suggest that adherence to a broad combination of healthy lifestyle factors was associated with a significantly reduced risk of mental health conditions during the COVID-19 pandemic. Lifestyle factors, in conjunction with socioeconomic deprivation, independently contribute to the risk of mental health issues. Although further research is needed to assess causality, the current findings support public health strategies and individual-level interventions that provide enhanced support in areas of deprivation and target multiple lifestyle factors to reduce health inequalities and promote mental well-being during the ongoing COVID-19 pandemic.

Psychometric Characteristics of the Brazil Mood Scale among Youth and Elite Athletes Using Two Response Time Frames.

Regular assessment of the mood construct as an indicator of psychological wellbeing is used in Brazil to screen athletes for risk of mental health issues. The present study tested the psychometric characteristics of the Brazil Mood Scale (BRAMS) using both "right now" and "past week" response time frames and investigated between-group differences in mood based on athletes' sex, age, and social vulnerability. Participants were 898 athletes (511 male, 387 female, age range: 12-44 years) from eight sports. The factorial validity of the BRAMS was supported using both response time frames independently and in a multi-sample analysis. Subscale reliability was supported for both time frames. Fatigue, depression, and tension scores were higher using the "past week" time frame than the "right now" time frame. Males reported higher vigor scores than females, and younger participants (<18 years) reported lower scores for anger and depression than older participants (18+ years). No significant differences in mood (p > 0.05) were found between participants identified as socially vulnerable and those who were not socially vulnerable. Findings supported the psychometric integrity of the BRAMS and its use as a screening measure for psychological wellbeing among youth and elite athletes in Brazil.

Mediating Effect of Stress Recognition on the Effect of Generalized Anxiety Disorder on Smartphone Dependence

The widespread adoption of the smartphone has led to both positive and negative consequences for adolescents’ mental health. This study examines the interplay between smartphone dependence (SPD), generalized anxiety disorder (GAD), and various mental health outcomes among Korean adolescents. Data from the 16th Adolescence Health Behavior Survey (2020), including 54,948 middle and high school students, were analyzed. Adolescents were categorized into three groups based on SPD severity. The GAD-7 scale assessed anxiety, and other factors such as subjective health recognition, happiness, weight control efforts, and body mass index (BMI) were considered. Adolescents with higher SPD exhibited lower academic performance, decreased happiness, and increased perception of stress. GAD levels were positively correlated with SPD, with higher SPD linked to more severe GAD symptoms. Additionally, higher SPD was associated with increased loneliness, sadness, and suicidal thoughts, plans, and attempts as well as a greater likelihood of habitual drug use. Gender differences revealed that females were more prone to sadness, hopelessness, and suicidal thoughts, while males exhibited higher rates of drug use. This study highlights the complex relationship between SPD, GAD, and mental health outcomes among Korean adolescents. Stress recognition was found to mediate the association between GAD and SPD. The process-macro result of the total effect between SPD on GAD and the direct effect of the SPD pathway on GAD was significant; thus, the stress recognition was mediated. Effective interventions should target stress management, especially among adolescents with high smartphone dependence, to mitigate the risk of mental health issues. These findings underscore the importance of addressing smartphone dependence and its impact on the mental well-being of adolescents.

Mental health first aid training among healthcare French students: a qualitative study.

Healthcare students are a population more at risk for mental health issues, especially anxiety, depression, and suicidal thoughts. The health faculty of Université Paris Cité in France, Paris has implemented a Mental Health First Aid (MHFA) course aiming to improve students' mental health literacy, self-care and peer-support and to decrease stigma about mental illness. We conducted a qualitative study exploring the lived experience of this MHFA training course among healthcare students so to better assess its implementation within this specific context and population. This qualitative study used the five-stage inductive process to analyze the structure of lived experience (IPSE) approach. All the healthcare students that had completed the 2-day MHFA training were approached to participate. Data was collected through individual semi-structured interviews and inclusion continued until data saturation was reached. Data analysis was based on an inductive, descriptive, and structuring procedure to determine the structure of lived experience characterized by the central axes of experience. Twenty students were included. Data analysis produced a common structure of lived experience based on three central axes of experience, (1) a personal experience, (2) a student experience and (3) a professional experience. The participants all experienced this course intertwined within these 3 axes. Their motivation to take the course was personal -being of feeling concerned by the topic-, was study-oriented - to learn and revise psychiatry- and was professional - so to develop both practical and soft skills. In their personal experience, participants reported a transformative experience and some interventions with friends and family, while both in their student and professional experience, they felt frustrated with both the content and the form of the course. The results reported similar outcomes reported in the literature about skills, knowledge, and awareness; but mostly produce original avenues about how to better adapt such course to this specific population so to better address students' expectations and mental health issues. This MHFA course -with an adapted content addressing eating disorders, self-mutilations and sexual and gender-based violence - could be part of the early curriculum of healthcare students. The latter could then benefit from a level 2/advanced MHFA course years later specifically tailored for healthcare professionals.

Anxiety and Depression in Early Gestation and the Association with Subsequent Gestational Diabetes Mellitus in a Disadvantaged Population

ObjectivesEvaluate the association between poor mental health and risk of developing gestational diabetes mellitus (GDM) in a cohort of women from a socioeconomically disadvantaged community.MethodsA total of 1363 nulliparous women with singleton pregnancies recruited to the Screening Tests to Predict Poor Outcomes of Pregnancy study in Adelaide, Australia. Women were assessed for mental health in the first trimester, including likelihood of depression, high functioning anxiety, perceived stress and risk of developing a mental health disorder. GDM was diagnosed based on the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. Socioeconomic status was measured using the New Zealand Socioeconomic Index (NZSEI).ResultsComplete mental health data was available for 1281 participants. There was no statistically significant difference in SEI, depression, risk of mental health issues, high functioning anxiety and perceived stress between women who developed GDM and those who did not. There was no difference in history of depression nor risk of developing a high mental health disorder in first trimester after adjusting for SEI, BMI in first trimester, smoking status in first trimester and maternal age between women with a GDM pregnancy and those who did not.Conclusions for PracticeThere was no difference in markers of poor mental health in early pregnancy between women who subsequently did or did not develop GDM. Cohort participants were socioeconomically disadvantaged, potentially contributing to the lack of apparent differences in depression observed between groups. Socioeconomically disadvantaged women should be targeted in pre-conception planning to reduce risk of GDM.

Civilian participants’ responses to veteran artwork: exploring empathy and understanding

ABSTRACT Background Military-to-civilian transition is complicated for U.S. veterans when civilians lack detailed knowledge of their experiences and military culture. Aims The purpose of this research was to: (1) examine the experiences of a group of civilian participants who viewed a veteran art exhibition and engaged in responsive art making, and (2) to identify participants understanding of military service and the veteran experience may shift as a result of participation in study activities. Methods Case study research was used to examine the experiences of a group of civilian participants who engaged in a workshop that involved viewing veteran artwork and making response art. Data were collected through surveys, participant artwork and written responses, and researcher observation. Case studies were presented using thick description with interpretive and linked narratives to interpret the results. Results Participant experiences demonstrated that the pilot study interventions promoted four outcomes: (1) authentic and meaningful exchanges and engagement with veterans (2) challenged to think about veterans’ experiences more deeply, (3) inspired to show support for people who have served in the military in new ways, and (4) promoted empathy and understanding. Conclusions Results illustrate how active participation in an art exhibition through response art making can help to increase understanding of people with different lived experiences by promoting authentic and meaningful exchanges through art. Implications for practice/policy/future research Interdisciplinary partnerships between art therapists and museum professionals can support the development of programming that bridges divides between groups with different lived experiences and prompts social change through participatory action. Plain-language summary Civilian citizens often lack a complete understanding of veteran experiences and military culture. A civilian citizen is a person who has not serve in the armed forces, and therefore may hold stereotypical beliefs or limited knowledge about veteran experiences. Misunderstandings and assumptions between civilian citizens and veterans can result in a cultural gap, often referred to as the military-civilian divide. This divide can impact the amount and quality of social support veterans receive from civilian citizens as they transition from the military back to civilian life. Poor social support may increase veterans’ risk for mental health issues. Therefore, there is a need for increased understanding of veteran experiences. Public spaces, like art museums, can help veteran experiences to be seen and heard by the larger civilian population. This study explores the experiences of a group of civilian citizens who participated in a workshop. The group of civilian participants viewed a veteran art exhibition and then engaged in making response art. Response art is a tool commonly used in the field of art therapy to express and share complex or difficult experiences. Participants also completed three surveys where they were asked questions about their understanding of veteran experiences. A review of participants survey answers and written responses showed how viewing and creating art promoted personal exchanges veterans, challenged participants to think about veterans’ experiences more deeply, inspired participants to show support for people who have served in the military in new ways, and promoted empathy and understanding. These outcomes show how art can be used to increase understanding across groups with different lived experiences.

Barriers and facilitators of older adults for professional mental health help-seeking: a systematic review

BackgroundOlder adults are at an increased risk for mental health issues, yet they are less likely to seek professional help. This systematic review aims to identify and summarize literature on the barriers and facilitators that older adults face when seeking professional mental health help.MethodsA comprehensive literature search was conducted using multiple databases including PubMed-Medline, EMBASE, ProQuest central, CINAHL and Scopus to identify relevant studies published between 2010 and 2021 that focused on barriers and/or facilitators to seeking help for depression, anxiety, and psychological distress among older adults aged 65 years or older. Studies’ risk of bias was assessed using the Newcastle–Ottawa Scale and results of studies were synthesized guided by the methodological framework of Rodgers and colleagues.ResultsA total of eight cross-sectional studies, from Australia, United States, Mexico, Netherlands, and Malaysia met the inclusion criteria for this review. Included studies reported that the majority of their participants had anxiety or depression, yet they exhibited a preference for informal mental health help over professional help. Stigma, negative beliefs about mental health professional services, and cost were the most reported barriers. Main reported facilitators were prior positive experience with mental health services and high socioeconomic status.ConclusionOlder adults are in need of interventions normalizing mental health help seeking and ensuring these services are accessible in terms of costs. This should be the focus of policy makers, healthcare providers, and public health practitioners working with older adults.Protocol registrationPROSPERO 2021 CRD42021238853.

Resilience as Moderator Between Posttraumatic Stress and Suicidal Ideation among Institutionalized Orphans

Abstract Background: Growing without parents is a big trauma in one’s life and after the death of parents children face so many problems that lead mental health problems. Orphans are the important part of our society as they are being neglected and this population is on risk, their mental health cannot be denied. Methods: In a current study a risk of mental health issues within a neglected population was studied. The moderating role of resilience has also been investigated in posttraumatic stress and suicidal ideation among institutionalized orphans. Sample (N=200) comprised equal number of girls and boys with age range 12-18 years, present in different orphan houses of Rawalpindi and Islamabad. Sample was selected through technique of convenient sampling. For data collection Ego Resilience Scale (ERS), Posttraumatic Stress Disorder Checklist and Beck Suicidal Ideation Scale were used. Results: Results indicated a significant positive relationship between posttraumatic stress and suicidal ideation, whereas resilience is negatively correlated with suicidal ideation and posttraumatic stress. Regression analysis showed that resilience proved to be a significant moderator between posttraumatic stress and suicidal ideation in orphans present in institutions. Further t-test analysis revealed significant gender differences on suicidal ideation while non-significant gender differences on posttraumatic stress and resilience. Conclusion: In this study risk and protective factors are explored. Risk factors are posttraumatic stress and suicidal ideation whether the protective factor is resilience. The relationship between posttraumatic stress and suicidal ideation is significantly moderated by Resilience. Key words: Orphans, posttraumatic stress, resilience, suicidal ideation