Risk Of Mental Health Disorders Research Articles

Chronic Mental Health Sequelae of Climate Change Extremes: A Case Study of the Deadliest Californian Wildfire.

Introduction. Weather-related disasters, such as wildfires exacerbated by a rise in global temperatures, need to be better studied in terms of their mental health impacts. This study focuses on the mental health sequelae of the deadliest wildfire in California to date, the Camp Fire of 2018. Methods. We investigated a sample of 725 California residents with different degrees of disaster exposure and measured mental health using clinically validated scales for post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD). Data were collected at a chronic time-point, six months post-wildfire. We used multiple regression analyses to predict the mental health outcomes based on self-reported fire exposure. Additionally, we included vulnerability and resilience factors in hierarchical regression analyses. Results. Our primary finding is that direct exposure to large scale fires significantly increased the risk for mental health disorders, particularly for PTSD and depression. Additionally, the inclusion of vulnerability and resilience factors in the hierarchical regression analyses led to the significantly improved prediction of all mental health outcomes. Childhood trauma and sleep disturbances exacerbated mental health symptoms. Notably, self-reported resilience had a positive effect on mental health, and mindfulness was associated with significantly lower depression and anxiety symptoms. Conclusion. Overall, our study demonstrated that climate-related extreme events, such as wildfires, can have severe mental illness sequelae. Moreover, we found that pre-existing stressful life events, resilient personality traits and lifestyle factors can play an important role in the prevalence of psychopathology after such disasters. Unchecked climate change projected for the latter half of this century may severely impact the mental wellbeing of the global population, and we must find ways to foster individual resiliency.

Escaping the inescapable: Risk of mental health disorder, somatic symptoms and resilience in Palestinian refugee children.

Exposure to war, conflict and forced migration puts children at risk of mental health problems. The present study examined the levels of psychological distress and resilience factors among 106 Palestinian refugee children aged 11 to 17 in the West Bank. In a cross-sectional, mixed method design along with qualitative interviews, three questionnaires were administered: the Strength and Difficulties Questionnaire and Patient Health Questionnaire-15, assessed the risk of mental health disorders and psychosomatic complaints, and the Child and Youth Resilience Measure assessed the availability of resilience-enhancing factors. Palestinian refugee children were found to be at greater risk for mental disorders and psychosomatic complaints than were children living in non-conflict affected settings. In addition, resilience-enhancing resources were significantly reduced and were negatively correlated with both symptom outcomes. Risk factors identified included poverty, violence and marginalisation. Key protective factors were youth education, supportive relationships and social participation. Our findings support interventions that address the identified protective factors, which may promote the mental health of this vulnerable population.

An Addressing on Risk of Mental Health Disorders Through Hybrid Takaful (Islamic Insurance): A Case of Malaysia

In addition to heart disease, other Malaysian extensive illnesses are mental health disorders. 29.2 per cent of Malaysians have recently suffered from mental illness, which has increased threefold compared to the previous year. The lowest income group accounts for the bulk of Malaysians suffering from mental illness. Currently, Singapore list among the countries has operative providing mental health insurance together with Australia, the United Kingdom and the United States of America. Malaysia is still far behind on offering mental health coverage with such a scheme only provided by AIA Malaysia. Therefore, through the takaful product, the purpose of this study is to address the risk of mental health disorders by hybrid takaful. The paper concluded that in order to maintain the promoting coverage and minimizing damage to mental health patients to human well-being, takaful mental health is needed in Malaysia market. In addition, this research would provide insight into the takaful industry for the development of a new and competitive product that could assist patients with a mental health disorder.

Loneliness and Mental Health Amongst Indians Working in Abu Dhabi, UAE

The high prevalence of loneliness has been evidenced to be directly associated with the risk of acquiring mental health disorders such as anxiety, depression and even susceptibility to suicide ideation if not address with long term mitigation practices. The risk of loneliness and mental health disorders have been evidenced to be higher across individuals living away from their native homelands. The Indian population has been estimated to comprise of one of the largest communities of expatriates residing in the UAE. It has been postulated that expatriates, though living a seemingly prosperous life, often encounter a range of adverse circumstances such as, loneliness, occupational distress, and concerns on occupational security which in turn, pave the way for increase prevalence of mental illnesses such as depression, stress and anxiety. Thus, the followed research aimed to evaluate the prevalence of loneliness, state of mental health and the subsequent risk of mental health disorders across Indians working in Abu Dhabi, UAE. To address the same, a quantitative cross-sectional design, coupled with data collection on demographics, mental health and social functioning were collected, using self-reported questions such as the General Health Functioning-28 and Social Functioning Questionnaire. Based on such findings, the sample was found to be equally distributed with respect to their risk of mental health illnesses and high level of social functioning, possibly due to equal inclusion of both participants who were living alone as well as not living alone. Additionally, the equal distribution of such risk as well as high levels of social functioning may also be attributed to demographic factors like age, education and occupational levels. There is thus a need to conduct further research on the role of specific demographic factors in influencing mental health status and social functioning across Indian expatriates residing in the UAE.

Factors Associated With College Students' Mental Health During the COVID-19 Pandemic

Factors Associated With College Students' Mental Health During the COVID-19 Pandemic Krista M. Soria (bio) and Bonnie Horgos (bio) In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the virus that causes coronavirus disease (COVID-19), was first reported in China. By March 11, 2020, the World Health Organization declared COVID-19 a global pandemic, forcing many higher education institutions to take measures to promote students' safety. The COVID-19 pandemic continues to upend the lives of students in higher education institutions. In particular, the pandemic has had deleterious effects on students' mental health, leading to increased prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD; Healthy Minds Network & American College Health Association [HMN], 2020). Students' mental health has become a paramount concern to institutional leaders: over 90% of college presidents expressed concern about students' mental health during the pandemic (Lederman, 2020). As faculty, student affairs practitioners, administrators, and mental health providers brace for the impact of increasing numbers of students who experience mental health disorders in upcoming semesters, they may benefit from an enhanced understanding of the students who are likely to experience mental health disorders and of the roles that other stressors or supports can play in students' mental health. The unique context surrounding the pandemic may create conditions that alter previous research findings related to students' mental health; therefore, we designed this study to examine the associations between individual, interpersonal, institutional, health, and stress-related factors and undergraduates' risks for clinically significant MDD and GAD. MENTAL HEALTH DISORDERS AMONG COLLEGE STUDENTS Even before the pandemic, the frequency of college students' mental health disorders was increasing at an alarming rate. Recent estimates indicate that 31% of students experienced GAD and 41% experienced MDD during the pandemic (HMN, 2020). College students are a particularly vulnerable group when it comes to their risk for mental health disorders, many of which first present themselves in late adolescence and early adulthood (Liu et al., 2020). Some of the variables associated with college students' mental health can be grouped into five broad categories: (a) individual characteristics (e.g., gender and sexual orientation), (b) interpersonal factors (e.g., sense of belonging), (c) institutional factors (e.g., perceptions of a supportive environment), (d) health and safety factors (e.g., nutrition and sleep), and, (e) stressors (e.g., financial and academic; Fink, 2014; [End Page 236] Oswalt & Wyatt, 2011). The unique conditions surrounding the COVID-19 pandemic might exacerbate the effects of some of the aforementioned factors on students' MDD and GAD. While emerging studies on college students' mental health during the COVID-19 pandemic present useful information to practitioners, the majority of those studies are limited because of small sample sizes, single-institution samples, or a limited number of independent variables (Huckins et al., 2020; Liu et al., 2020). We examined a wide variety of factors associated with college students' rates of MDD and GAD with variables specific to students' experiences during the pandemic; our sample was drawn from 8 large, public research universities; and, our sample size allowed us to examine the effects among demographic groups typically excluded in studies because of their small numbers. CONCEPTUAL FRAMEWORK We drew from Fink's (2014) integrated model of college students' mental health, which combines Astin's (1993) input–environment–outcome model, the VicHealth framework (Keheler & Armstrong, 2005), and Keyes's (2002) mental health continuum. Fink examined the effects of students' individual characteristics, interpersonal factors, and institutional factors on students' mental health. We extended Fink's framework by adding stressors that we theorized would impact students' mental health, including health and safety factors and financial and academic stressors. METHOD Instrument and Sample We used the Student Experience in the Research University (SERU) COVID-19 survey, developed by members of the SERU Consortium. Eight large, public research universities located in different regions of the US administered the census survey in June and July 2020. The response rates ranged from 13% to 30%, 90% of students answered all items in the survey; we excluded responses with missing data, and the final sample was N = 27,118. Detailed information about the sample is available in Table 1. Measures Our individual measures include...

The Role of COVID-19 in Transitioning to a Better Pediatric Payment Model

* Abbreviations: COVID-19 — : coronavirus disease 2019 PMPM — : per member per month The coronavirus disease 2019 (COVID-19) pandemic has quickly impacted health care systems and especially primary care pediatricians. Although fortunately cases of severe COVID-19 and the associated multisystem inflammatory syndrome in children have been rare, the disruptions caused by the COVID-19 pandemic have exposed the financial vulnerability of independent pediatric practices that rely primarily on fee-for-service revenue. Social distancing and stay-at-home advisories have led to the cancellation of routine well-child and follow-up visits for many children and young adults nationwide, as evidenced by the steep drop in childhood vaccines since March.1 Furthermore, social distancing has led to a significant reduction in the incidence of common infections and playground and sports injuries, further diminishing the need for office visits.2 And, even when children do become ill or injured, parents fear exposing their children to infection by bringing them for care during the pandemic. Yet although children have been relatively spared from the brunt of direct health effects of COVID-19, social isolation and lack of school attendance have placed them at increased risk for mental health disorders, missed screenings for lead poisoning, poor nutrition and/or exercise habits, and undetected child abuse, which are situations that call for a strengthening of the primary care infrastructure to assure children’s health needs are met. In our own affiliated primary care network, in-person visits initially fell by ∼75% after statewide … Address correspondence to Michael A. Lee, MD, MBA, Department of Accountable Care and Clinical Integration, Boston Children’s Hospital, 300 Longwood Ave, Mailstop 3196, Boston, MA 02115. E-mail: michael.lee2{at}childrens.harvard.edu

Female sex and food insecurity in relation to self-reported poor or fair mental health in Canadian adults: a cross-sectional study using national survey data.

Background:Women with food insecurity are at higher risk for mental health disorders. This study examined the joint effect of female sex and food insecurity on self-reported poor or fair mental health in Canadian adults.Methods:The analysis was based on data from adults (age ≥ 18 yr) who participated in the Canadian Community Health Survey (CCHS) 2015–2016. We determined past-year food security level (secure, moderately insecure or severely insecure) based on 18 questions. We used log-binomial regression to explore associations of sex and food insecurity with self-reported poor or fair mental health. We measured additive interaction between female sex and food insecurity using relative excess risk due to interaction (RERI).Results:The overall response rate for the CCHS was 59.5%. Data for 61 446 respondents were analyzed. Poor or fair mental health was reported by 4107 participants (6.1% when weighted to the Canadian population). Increased risk of poor or fair mental health was associated with female sex (prevalence ratio [PR] 1.22, 95% confidence interval [CI] 1.12 to 1.31), and moderate (PR 2.50, 95% CI 2.21 to 2.82) and severe (PR 4.03, 95% CI 3.59 to 4.52) food insecurity. Significant additive interaction between female sex and severe food insecurity was found for those aged 40–64 years (RERI 1.38, 95% CI 0.29 to 2.47), and the PR for poor or fair mental health for severely food-insecure women was 5.55 (95% CI 4.48 to 6.89) compared to food-secure men of the same age group.Interpretation:Poor or fair mental health is common in the food-insecure population, and there exists synergism between female sex and severe food insecurity among middle-aged people. This suggests the need to develop targeted mental health support strategies for food-insecure people, specifically middle-aged women.

Depression, Anxiety, and Lifestyle Among Essential Workers: A Web Survey From Brazil and Spain During the COVID-19 Pandemic.

BackgroundEssential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders.ObjectiveWe aimed to assess the prevalence and predictors of depression, anxiety, and their comorbidity among essential workers in Brazil and Spain during the COVID-19 pandemic.MethodsA web survey was conducted between April and May 2020 in both countries. The main outcome was a positive screening for depression only, anxiety only, or both. Lifestyle was measured using a lifestyle multidimensional scale adapted for the COVID-19 pandemic (Short Multidimensional Inventory Lifestyle Evaluation–Confinement). A multinomial logistic regression model was performed to evaluate the factors associated with depression, anxiety, and the presence of both conditions.ResultsFrom the 22,786 individuals included in the web survey, 3745 self-reported to be essential workers. Overall, 8.3% (n=311), 11.6% (n=434), and 27.4% (n=1027) presented positive screenings for depression, anxiety, and both, respectively. After adjusting for confounding factors, the multinomial model showed that an unhealthy lifestyle increased the likelihood of depression (adjusted odds ratio [AOR] 4.00, 95% CI 2.72-5.87), anxiety (AOR 2.39, 95% CI 1.80-3.20), and both anxiety and depression (AOR 8.30, 95% CI 5.90-11.7). Living in Brazil was associated with increased odds of depression (AOR 2.89, 95% CI 2.07-4.06), anxiety (AOR 2.81, 95%CI 2.11-3.74), and both conditions (AOR 5.99, 95% CI 4.53-7.91).ConclusionsInterventions addressing lifestyle may be useful in dealing with symptoms of common mental disorders during the strain imposed among essential workers by the COVID-19 pandemic. Essential workers who live in middle-income countries with higher rates of inequality may face additional challenges. Ensuring equitable treatment and support may be an important challenge ahead, considering the possible syndemic effect of the social determinants of health.

Vitamin D Deficiency in a Minnesota-Based Foster Care Population: A Cross Sectional Study.

Children in foster care have complex health concerns that often interplay with their childhood experiences, environment and access to care. Studies suggest that foster care youth are at an increased risk for mental health disorders and physical disabilities. Although traditionally associated with insufficient bone development, the implications of vitamin D deficiency are broadening to encompass behavioral, neurodevelopmental, and psychological phenomena. Due to its association with diet, prenatal factors, and the prevalence of nutrition related deficiencies in foster care patients, we hypothesize that foster care patients exhibit lower levels of total 25-hydroxy vitamin D [25(OH)D] than the general pediatric population. A retrospective cross-sectional chart review of foster care patients and similar-aged non-fostered controls screened for vitamin D deficiency was conducted between January 2013 and May 2018 (n=407). Twenty-five (OH)D levels were comparable between foster care children and controls (p=0.771). A univariate analysis of risk factors within the foster care group found that higher BMI, older age, ADHD, and number of transitions was associated with decreased levels of 25(OH)D. Recognition and treatment of low 25(OH)D in foster care patients with specific risk factors may serve as an adjunct for meeting their medical and psychosocial needs.

COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan

BackgroundCOVID-19 is a global pandemic and has become a major public health burden worldwide. With already fragile healthcare systems it can have long lasting effects in developing countries. Outbreaks especially a pandemic situation evokes fear related behaviors among healthcare professionals and there is always an increased risk of mental health disorders. Therefore, this study aims to determine knowledge and perception about this pandemic, prevalence and factors associated with anxiety/depression among frontline physicians of Pakistan.MethodsData were collected through an online survey released in the last week of March-2020. 389 frontline physicians from all four provinces and 65 cities of Pakistan participated. Survey questionnaire consisted of 4 parts including informed consent section, demographic section, knowledge and perception about COVID-19 pandemic and assessment of depression through World Health Organization Self-reporting questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cut-off to label the participant as depressed. Data was analyzed using SPSS version22.ResultsA 43% prevalence of anxiety/depression among frontline physicians of Pakistan was reported. Almost all the doctors had moderate to high knowledge score. Majority of participants marked N-95 mask as “essential” during aerosol generating procedures, assessing patients with respiratory symptoms, in COVID patient-care area, ER triage and direct care of COVID-19 patient. Only 12% of the doctors were fully satisfied with the provision of PPEs and almost 94% felt unprotected.In multivariable model, assessing more than five COVID suspects/day (aOR = 2.73, 95% CI: 1.65–4.52), working 20 h/week or less (aOR = 2.11, 1.27–3.49), having children among household members (aOR = 1.58, 95% CI: 1.00–2.50) and moderate to low knowledge of the infection (aOR = 2.69, 95% CI: 1.68–4.31) were found to be independent predictors of anxiety/depression among physicians.ConclusionAnxiety/depression among more than a third of frontline doctors of Pakistan warrants the need to address mental health of doctors caring for patients during this pandemic; control modifiable factors associated with it and explore the effectiveness of interventions to promote psychological well-being of physicians.

A cross-sectionally analysis of two dietary quality indices and the mental health profile in female adults

Some studies have pointed out that several dietary patterns could be associated with a reduced risk of depression. The association of overall dietary quality incidences with risk of mental health disorders is limited. We investigated associations of current mental health outcomes with two diet quality indices. We included 977 female participants who came to the social facility of the Ankara Metropolitan Municipality. Dietary intake was collected with a 24-h dietary recall interview, which was used to develop a Healthy Eating Index (HEI)-2015. A Mediterranean diet adherence was measured with the Prevention with Mediteranean Diet (PREDIMED) and the depression, anxiety and stress scale (DASS)-42 was used to assess common psychological disorders. Associations between mental health outcomes and the diet indices were analysed by logistic regression models. Inverse and significant associations were observed between the two diet quality scores and mental health disorders. After fully adjustment, participants in the high group of PREDIMED score had diminished odds of depression (Odds ratio (OR): 0.39, 95% confidence interval (CI): 0.25–0.58), anxiety (OR: 0.68, 95% CI: 0.46–1.00), and stress (OR: 0.42, 95% CI: 0.28–0.65) than those in the low group. A lower HEI-2015, which shows a weaker relationship with mental health results according to PREDIMED results, showed persisted depressive and anxiety symptoms after fully adjustment. Our study suggests that mental health outcomes and symptoms are associated with a poorer diet quality, particularly in PREDIMED.

Perinatal Distress During COVID-19: Thematic Analysis of an Online Parenting Forum.

BackgroundThe COVID-19 global pandemic has impacted the whole of society, requiring rapid implementation of individual-, population-, and system-level public health responses to contain and reduce the spread of infection. Women in the perinatal period (pregnant, birthing, and postpartum) have unique and timely needs for directives on health, safety, and risk aversion during periods of isolation and physical distancing for themselves, their child or children, and other family members. In addition, they are a vulnerable group at increased risk of psychological distress that may be exacerbated in the context of social support deprivation and a high-risk external environment.ObjectiveThe aim of this study is to examine the public discourse of a perinatal cohort to understand unmet health information and support needs, and the impacts on mothering identity and social dynamics in the context of COVID-19.MethodsA leading Australian online support forum for women pre- through to postbirth was used to interrogate all posts related to COVID-19 from January 27 to May 12, 2020, inclusive. Key search terms included “COVID,” “corona,” and “pandemic.” A three-phase analysis was conducted, including thematic analysis, sentiment analysis, and word frequency calculations.ResultsThe search yielded 960 posts, of which 831 were included in our analysis. The qualitative thematic analysis demonstrated reasonable understanding, interpretation, and application of relevant restrictions in place, with five emerging themes identified. These were (1) heightened distress related to a high-risk external environment; (2) despair and anticipatory grief due to deprivation of social and family support, and bonding rituals; (3) altered family and support relationships; (4) guilt-tampered happiness; and (5) family future postponed. Sentiment analysis revealed that the content was predominantly negative (very negative: n=537 and moderately negative: n=443 compared to very positive: n=236 and moderately positive: n=340). Negative words were frequently used in the 831 posts with associated derivatives including “worried” (n=165, 19.9%), “risk” (n=143, 17.2%), “anxiety” (n=98, 11.8%), “concerns” (n=74, 8.8%), and “stress” (n=69, 8.3%).ConclusionsWomen in the perinatal period are uniquely impacted by the current pandemic. General information on COVID-19 safe behaviors did not meet the particular needs of this cohort. The lack of nuanced and timely information may exacerbate the risk of psychological and psychosocial distress in this vulnerable, high-risk group. State and federal public health departments need to provide a central repository of information that is targeted, consistent, accessible, timely, and reassuring. Compensatory social and emotional support should be considered, using alternative measures to mitigate the risk of mental health disorders in this cohort.

Changes in mental health and drug use among men who have sex with men using daily and event-driven pre-exposure prophylaxis: Results from a prospective demonstration project in Amsterdam, the Netherlands.

BackgroundGay, bisexual and other men who have sex with men (GBMSM) are at increased risk of mental health disorders and drug use. In GBMSM taking pre-exposure prophylaxis (PrEP) for HIV, the proportion engaging in risk behaviors could increase due to decreased perception in HIV risk. In turn, this could leave them further susceptible to mental health disorders.MethodsThe AMsterdam PrEP study (AMPrEP) is a demonstration project offering a choice of daily PrEP or event-driven PrEP regimen at the STI clinic of the Public Health Service of Amsterdam. Eligible participants were HIV-negative GBMSM and transgender people at risk of HIV, aged ≥18 years. We assessed anxiety and depressive mood disorders (Mental Health Inventory 5), sexual compulsivity (Sexual Compulsivity Scale), alcohol use disorder (Alcohol Use Disorder Identification Test), and drug use disorder (Drug Use Disorder Identification Test) using yearly self-administered assessments (August 2015–September 2018). The proportion of mental health problems were analyzed and changes over time and between regimen were assessed using a logistic regression model. Variables associated with the development or recovery of disorders were assessed using a multistate Markov model.OutcomesOf 376 enrolled, we analyzed 341 participants with data at baseline and at least one follow-up visit. During a median follow-up of 2.5 years (IQR=2.3–2.7), the proportion assessed with sexual compulsivity decreased from 23% at baseline to 10% at the last visit (p<0.001) and drug use disorder decreased from 38% at baseline to 31% at the last visit (p = 0.004). No changes occurred in proportion assessed with anxiety/depressive mood disorders (20% at baseline, 18% at last visit, p = 0.358) or alcohol use disorder (28% at baseline, 22% at the last visit, p = 0.106). During follow-up, participants reported significant less use of alcohol (p<0.001), nitrites (p<0.001) and ecstasy (p<0.001). We found no differences between daily and event-driven PrEP users. The development and recovery of disorders during follow-up were highly interrelated.InterpretationMental health disorders are prevalent among those initiating PrEP. We did not find increases in mental health disorders during PrEP use, but rather a decrease in sexual compulsivity and drug use disorders. The initial prevalence of mental health disorders in our study point at the continuous need to address mental health disorders within PrEP programs.FundingZonMw, H-TEAM, Internal GGD research funds, Aidsfonds, Stichting AmsterdamDiner Foundation, Gilead Sciences, Janssen Pharmaceutica, M A C AIDS Fund, and ViiV Healthcare.

Novel Factors Associated With Adverse Mental Health In Elite Para Athletes In South Africa

Para-athletes (PA) may have specific mental health (MH) challenges that, together with the demands of high-level sport performance, could put them at risk for MH disorders. However, research in this population is limited. PURPOSE: To investigate factors associated with MH in South African PA. METHODS: In this descriptive, cross-sectional study, 124 athletes (93 males; 31 females) with a mean age 26.7 (±9.2) competing in the 2019 National Champs were recruited. Demographic, medical history and sleep-related variables were included in bivariate analyses to assess their association with MH. Between-group differences were analysed using the Mann-Whitney U or T-tests. Variables significantly associated in the bivariate analyses were included in multiple regression analyses for mental health. Mental health was measured with the State/Trait Anxiety Inventory (STAI) and the Kessler Psychological Distress Scale (K-10 Questionnaire). Sleep quality, sleepiness and chronotype were measured with the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness scale and Morningness-Eveningness Questionnaire (MEQ-SA). RESULTS: The model explained 40% of the variance in MH (F=12.04, p<0.001). Compared to athletes with ‘good’ sleep quality, K-10 and STAI scores were significantly higher (indicating poorer MH) in athletes with ‘poor’ sleep quality (U =2.6, p<0.001; t(116.8)=-4.30, p<0.001). ‘Poor’ sleep quality (B:0.8; 95%CI 0.4 to 1.3), moderate to severe daytime sleepiness (B:4.2; 95%CI 1.1 to 7.3) intermediate (B:3.5 95%CI 0.4 to 6.6) and evening chronotypes (B:12.0 95%CI 5.0 to 19.1), the presence of allergies (B:3.9 95%CI 0.1 to 7.6) and male gender (B:3.3 95%CI 0.1 to 6.5) were most strongly associated with high STAI scores. CONCLUSIONS: This study identified novel factors associated with adverse MH in elite PA. As some of these factors are modifiable, further research towards prevention strategies is warranted.

Sitting Time Predicts Cortisol Levels In Women, Independent Of Cardiorespiratory Fitness Level

PURPOSE: Research suggests that sitting time may be an independent predictor of negative health outcomes, even after accounting for physical activity (PA) participation. There is limited investigation of the association between sitting time and mental health outcomes, and the mechanisms by which sitting time may increase the risk for mental health disorders are not completely understood. Considering that cortisol [an index of hypothalamic pituitary adrenal axis regulation] has been shown to be a robust predictive biomarker for depression and anxiety disorder risk, this study aimed to investigate whether sitting time was associated with salivary cortisol levels in women, and whether this relationship remained significant after controlling for indices of physical fitness. METHODS: Twenty-one healthy women [18-45y, mean age: 23.9 +/- 6.3y; mean body mass index (BMI): 23.9 +/- 4.6] who were medication-free and had regular menstrual cycles completed (1) self-report of weekly PA and weekly sitting time; (2) assessment of cardiorespiratory fitness (CRF) via maximal oxygen consumption during exercise; (3) one-week recording of sleep and activity patterns by wrist actigraphy; and (4) measurement of salivary cortisol levels (collected during the follicular phase of the ovarian cycle in order to control for the influence of ovarian cycle hormone fluctuations on salivary cortisol). RESULTS: Regression analysis revealed that greater total sitting time/week significantly predicted higher cortisol levels in women (ß= 0.71, p< 0.001), and this relationship remained significant after controlling for age, BMI, and CRF level (ß= 0.67, p< 0.01). Additionally, greater total sitting time/week was significantly associated with lower actigraph-measured PA (activity counts/min; r = -.57 p < 0.01). CONCLUSIONS: Results suggest that, although greater total sitting time was associated with a reduced amount of daily PA, greater total sitting time may still predict higher salivary cortisol levels, independent of indices of fitness (BMI and CRF). It is possible that the stress-related mechanisms underlying the relationship between sitting time and depression and anxiety risk may be related to sitting time itself, and not a simply a product of reduced daily PA. Further investigation is needed to explore these associations.

Enacted HIV-Related Stigma's Association with Anxiety & Depression Among People Living with HIV (PLWH) in Florida.

Research has shown that HIV-related stigma contributes to people living with HIV having a higher risk of mental health disorders. Our study examines the association between enacted HIV-related stigma and symptoms of anxiety and depression among PLWH. We used baseline data from 932 PLWH collected from the Florida Cohort study between 2014 and 2018. The sample was majority 45 + years of age (63.5%), male (66.0%), and Black (58.1%). The majority had previously experienced enacted HIV-related stigma (53.1%). Additionally, 56.6% and 65.2% showed mild to moderate/severe levels of anxiety and depression, respectively. Those who experienced any levels of enacted HIV-related stigma (vs none) had significantly greater odds of mild and moderate/severe levels of anxiety (vs no/minimal) (AOR[CI] 1.54[1.13, 2.10], p = 0.006; AOR[CI] 3.36[2.14, 5.26], p < 0.001, respectively) and depression (AOR[CI] 1.61[1.19, 2.18], p = 0.002; AOR[CI] 3.66[2.32, 5.77], p < 0.001, respectively). Findings suggest a need to evaluate interventions for PLWH to reduce the deleterious effects of enacted HIV-related stigma on mental health.

Prevalence and psychopathologic significance of hallucinations in individuals with a history of seizures

A relationship between seizure activity and hallucinations is well established. The psychopathologic significance of hallucinations in individuals with seizures, however, is unclear. In this study, we assessed the prevalence of auditory and visual hallucinations in individuals who reported a seizure history and investigated their relationship with a number of mental disorders, suicidal ideation, and suicide attempts. Data were from the "Adult Psychiatric Morbidity Survey," a population-based cross-sectional survey. Auditory and visual hallucinations were assessed using the Psychosis Screening Questionnaire. Mental health disorders were assessed using the Clinical Interview Schedule. Logistic regressions assessed relationships between hallucinatory experiences and mental disorders, suicidal ideation, and suicide attempts. A total of 14812 adults (58% female; mean [standard error of the mean; SEM] age 51.8 [0.15]) completed the study; 1.39% reported having ever had seizures (54% female), and 8% of individuals with a seizure history reported hallucinatory experiences (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.24-3.38). Individuals with seizures had an increased odds of having any mental disorder (OR 2.34, 95% CI 1.73-3.16), suicidal ideation (OR 2.38, 95% CI 1.77-3.20), and suicide attempt (OR 4.15, 95% CI 2.91-5.92). Compared to individuals with seizures who did not report hallucinatory experiences, individuals with seizures who reported hallucinatory experiences had an increased odds of any mental disorder (OR 3.47, 95% CI 1.14-10.56), suicidal ideation (OR 2.58, 95% CI 0.87-7.63), and suicide attempt (OR 4.61, 95% CI 1.56-13.65). Overall, more than half of individuals with a seizure history who reported hallucinatory experiences had at least one suicide attempt. Adjusting for psychopathology severity did not account for the relationship between hallucinatory experiences and suicide attempts. Hallucinatory experiences in individuals with seizures are markers of high risk for mental health disorders and suicidal behavior. There is a particularly strong relationship between hallucinations and suicide attempts in individuals with seizures. Clinicians working with individuals with seizures should routinely ask about hallucinatory experiences.

Association of High-Potency Cannabis Use With Mental Health and Substance Use in Adolescence

Cannabis use is consistently linked to poorer mental health outcomes, and there is evidence that use of higher-potency cannabis increases these risks. To date, no studies have described the association between cannabis potency and concurrent mental health in a general population sample or addressed confounding using longitudinal data. To explore the association between cannabis potency and substance use and mental health outcomes, accounting for preceding mental health and frequency of cannabis use. This cohort study used data from the Avon Longitudinal Study of Parents and Children, a UK birth cohort of participants born between April 1, 1991, and December 31, 1992. Present data on outcomes and exposures were collected between June 2015 and October 2017 from 1087 participants at 24 years of age who reported recent cannabis use. Self-reported type of cannabis most commonly used in the past year, coded to a binary exposure of use of high-potency cannabis or lower-potency cannabis. Outcomes were reported frequency of cannabis use, reported cannabis use problems, recent use of other illicit drugs, tobacco dependence, alcohol use disorder, depression, generalized anxiety disorder, and psychotic-like experiences. The study used secondary data; consequently, the hypotheses were formulated after data collection. Past-year cannabis use was reported by 1087 participants (580 women; mean [SD] age at onset of cannabis use, 16.7 [3.0] years). Of these, 141 participants (13.0%) reported the use of high-potency cannabis. Use of high-potency cannabis was associated with increased frequency of cannabis use (adjusted odds ratio [AOR], 4.38; 95% CI, 2.89-6.63), cannabis problems (AOR, 4.08; 95% CI, 1.41-11.81), and increased likelihood of anxiety disorder (AOR, 1.92; 95% CI, 1.11-3.32). Adjustment for frequency of cannabis use attenuated the association with psychotic experiences (AOR 1.29; 95% CI, 0.67-2.50), tobacco dependence (AOR, 1.42; 95% CI, 0.89-2.27), and other illicit drug use (AOR, 1.29; 95% CI, 0.77-2.17). There was no evidence of association between the use of high-potency cannabis and alcohol use disorder or depression. To our knowledge, this study provides the first general population evidence suggesting that the use of high-potency cannabis is associated with mental health and addiction. Limiting the availability of high-potency cannabis may be associated with a reduction in the number of individuals who develop cannabis use disorders, the prevention of cannabis use from escalating to a regular behavior, and a reduction in the risk of mental health disorders.

Closed-loop digital meditation for neurocognitive and behavioral development in adolescents with childhood neglect

Adverse childhood experiences are linked to poor attentive behaviors during adolescence, as well as increased risk for mental health disorders in adults. However, no study has yet tested targeted interventions to optimize neurocognitive processes in this population. Here, we investigated closed-loop digital interventions in a double-blind randomized controlled study in adolescents with childhood neglect, and evaluated the outcomes using multimodal assessments of neuroimaging, cognitive, behavioral, and academic evaluations. In the primary neuroimaging results, we demonstrate that a closed-loop digital meditation intervention can strengthen functional connectivity of the dorsal anterior cingulate cortex (dACC) in the cingulo-opercular network, which is critically developing during the adolescent period. Second, this intervention enhanced sustained attention and interference-resolution abilities, and also reduced behavioral hyperactivity at a 1-year follow-up. Superior academic performance was additionally observed in adolescents who underwent the digital meditation intervention. Finally, changes in dACC functional connectivity significantly correlated with improvements in sustained attention, hyperactivity, and academic performance. This first study demonstrates that closed-loop digital meditation practice can facilitate development of important aspects of neurocognition and real-life behaviors in adolescents with early childhood neglect.

Fear-Potentiated Startle Prospectively Predicts Alcohol Use Patterns in Individuals Exposed to Trauma

Exposure to trauma increases risk for mental health disorders, including substance use. As a putative biomarker for PTSD, fear-potentiated startle (FPS) may also have clinical utility as a predictive biomarker for substance use disorders in the context of trauma exposure. This study recruited participants in the Emergency Department (ED) as part of the AURORA study; we hypothesized that FPS immediately following trauma would predict more severe substance use later.