Self-report Measures Of Mental Health Research Articles

The Ambiguous Cue Task: Measurement reliability of an experimental paradigm for the assessment of interpretation bias and associations with mental health.

Interpretation biases in the processing of ambiguous affective information are assumed to play an important role in the onset and maintenance of emotional disorders. Reports of low reliability for experimental measures of cognitive biases have called into question previous findings on the association of these measures with markers of mental health and demonstrated the need to systematically evaluate measurement reliability for measures of cognitive biases. We evaluated reliability and correlations with self-report measures of mental health for interpretation bias scores derived from the Ambiguous Cue Task (ACT), an experimental paradigm for the assessment of approach-avoidance behavior towards ambiguous affective stimuli. For a non-clinical sample, the measurement of an interpretation bias with the ACT showed high internal consistency (rSB = .91 - .96, N = 354) and acceptable 2-week test-retest correlations (rPearson = .61 - .65, n = 109). Correlations between the ACT interpretation bias scores and mental health-related self-report measures of personality and well-being were generally small (r ≤ |.11|) and statistically not significant when correcting for multiple comparisons. These findings suggest that in non-clinical populations, individual differences in the interpretation of ambiguous affective information as assessed with the ACT do not show a clear association with self-report markers of mental health. However, in allowing for a highly reliable measurement of interpretation bias, the ACT provides a valuable tool for studies considering potentially small effect sizes in non-clinical populations by studying bigger samples as well as for work on clinical populations, for which potentially greater effects can be expected.

The dynamics of emotion expression on Twitter and mental health in a UK longitudinal study

Introduction & BackgroundAn estimated 4.95 billion people used social media in 2023, with the average user active on around seven platforms for over two hours per day. This widespread use leads to abundant digital footprint data around interactions with social media. These data can be collected continuously and reflect real behaviour of users in naturalistic settings. These strengths have led researchers to propose the use of social media data in digital phenotyping, where digital footprints can be used to quantify and predict health conditions. Mental health assessment in particular could benefit, as existing approaches, such as self-report questionnaires and inpatient assessment, are unable to perform the real-time monitoring that digital phenotyping could potentially achieve. Digital phenotyping models for mental health require careful consideration of what aspects of social media data to include. Including all data users generate could result in models that are overfitted and difficult to explain. Studies are required that explore the relationship between specific aspects of social media data, such as the time course of expressed emotion, and gold-standard measures of mental health. Objectives & ApproachWith participants’ consent, we linked Twitter data to self-reported measures of mental health from the Avon Longitudinal Study of Parents and Children. We performed sentiment analysis using three different approaches—LIWC, VADER and RoBERTa—to estimate the amount, variability and instability of positive and negative emotional content in each participant’s Tweets over a one-year period. We explored the association between these measures of emotion expression and self-reported scores of depressive symptoms, anxiety symptoms and wellbeing. These mental health measures are the Short Mood and Feelings Questionnaire, the Generalized Anxiety 7 and the Warwick Edinburgh Mental Wellbeing Scale. Relevance to Digital FootprintsOur research is highly relevant to digital footprint research, as it involves the use of digital footprint data (i.e. Twitter data) to predict mental health outcomes. Conclusions & ImplicationsThe results of our analysis will inform the development of digital footprint based phenotyping for mental health that could one day provide information to supplement clinical assessments.

Quality of mother-infant interaction, breastfeeding, and perinatal mental health

IntroductionThe quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a positive mother-infant bond. Maternal mental health difficulties negatively impact both maternal sensitivity and breastfeeding. Thus, it is unclear whether breastfeeding contributes to the quality of mother-infant interactions independent from mental health. The purpose of this study is to examine the contribution of exclusive breastfeeding at 3 months postpartum to the quality of the mother-infant relationship at 6 months postpartum, controlling for maternal mental health in a community sample of mothers in Chile. Materials and methodEighty women completed self-report measures of mental health and breastfeeding during the third trimester of pregnancy and 3 and 6 months postpartum. At 6 months after childbirth, the mother-infant interaction was assessed by coding a free-play session between mothers and infants. Logistic regression analysis was used to examine the contribution of breastfeeding practices and mental health to the quality of mother-infant interactions. ResultsExclusive breastfeeding at 3 months postpartum increased the likelihood of displaying positive mother-infant interactions controlling for maternal mental health. Mothers who continued to breastfeed at 6 months postpartum reported less symptoms of antenatal depression and anxiety and higher levels of sensitivity and cooperation towards their infants. ConclusionBreastfeeding contributes to maternal sensitivity and cooperation even when controlling for maternal mental health. Implications for health practitioners and limitations due to the sample characteristics are discussed.

Patient-reported outcome measures in early psychosis: A cross-cultural, longitudinal examination of the self-reported health and self-reported mental health measures in Chennai, India and Montreal, Canada

ObjectiveDespite their acknowledged value, patient-reported outcome measures (PROMs) are infrequently used in psychosis, particularly in low-and middle-income countries. We compared ratings on two single-item PROMs, Self-Rated Health (SRH) and Self-Rated Mental Health (SRMH), of persons receiving similar early psychosis services in Chennai, India and Montreal, Canada. We hypothesized greater improvements in SRH and SRMH in the Chennai (compared to the Montreal) sample. MethodsParticipants (Chennai N = 159/168 who participated in the larger study; Montreal N = 74/165 who participated in the larger study) completed the SRH and SRMH during at least two out of three timepoints (entry, months 12 and 24). Repeated measures proportional odds logistic regressions examined the effects of time (baseline to month 24), site, and relevant baseline (e.g., gender) and time-varying covariates (i.e., symptoms) on SRH and SRMH scores. ResultsSRH (but not SRMH) scores significantly differed between the sites at baseline, with Chennai patients reporting poorer health (OR: 0.33; CI: 0.18, 0.63). While Chennai patients reported similar significant improvements in their SRH (OR: 7.03; CI: 3.13; 15.78) and SRMH (OR: 2.29, CI: 1.03, 5.11) over time, Montreal patients only reported significant improvements in their SRMH. Women in Chennai (but not Montreal) reported lower mental health than men. Higher anxiety and longer durations of untreated psychosis were associated with poorer SRH and SRMH, while negative symptoms were associated with SRH. ConclusionsAs hypothesized, Chennai patients reported greater improvements in health and mental health. The marked differences between health and mental health in Montreal, in contrast to the overlap between the two in Chennai, aligns with previous findings of clearer distinctions between mind and body in Western societies. Cross-context (e.g., anxiety) and context-specific (e.g., gender) factors influence patients' health perceptions. Our results highlight the value of integrating simple PROMs in early psychosis.

The association between exposure to hate speech or perceived discrimination and mental health problems among Korean residents in Japan.

This study evaluated the effect of perceived discrimination and racism on the mental health state of Korean residents in Japan, with a particular focus on the risk of post-traumatic stress disorder (PTSD), depression, and psychological distress. Surveys were sent to Korean residents in Japan and a total of 240 valid responses were received. The valid response rate was 27.1%. The participants answered several questionnaire items, including demographic information and questions pertaining to their experiences of perceived discrimination, along with three self-reported measures of mental health, i.e., the Japanese version of Impact of Event Scale-Revised, the Zung Self-rating Depression Scale (SDS), and the 12-item General Health Questionnaire (GHQ-12). The results indicated that Korean residents in Japan experience hate speech and discrimination with a markedly high frequency (92.9% and 100%, respectively), and that factors such as employment discrimination and exposure to hate speech via social networking services were significant predictors of probable PTSD and psychological distress.

Patient-reported outcome measures in early psychosis: Evaluating the psychometric properties of the single-item self-reported health and self-reported mental health measures in Chennai, India and Montreal, Canada.

Patient-reported outcome measures (PROMs) provide valuable information and promote shared decision-making but are infrequently used in psychosis. Self-rated Health (SRH) and Self-rated Mental Health (SRMH) are single-item PROMs in which respondents rate their health and mental health from 'poor' to 'excellent'. We examined the psychometric properties of the SRH and SRMH in early psychosis services in Chennai, India and Montreal, Canada. Assessments were completed in Tamil/English in Chennai and French/English in Montreal. Test-retest reliability included data from 59 patients in Chennai and Montreal. Criterion validity was examined against clinician-rated measures of depression, anxiety, positive and negative symptoms, and a quality-of-life PROM for 261 patients in Chennai and Montreal. SRH and SRMH had good to excellent test-retest reliability (ICC >0.63) at both sites and in English and Tamil (but not French). Results for criterion validity were mixed. In Montreal, low SRH was associated with not being in positive symptom remission, and poorer functioning and quality of life. SRH was associated only with functioning in Chennai. No associations were found for SRMH in Montreal. In Chennai, low SRMH was associated with not being in positive symptom remission and poorer functioning. Patient-reported outcome measures may perform differently across contexts as a potential function of variations in sociodemographics, illness characteristics/course, understandings of health/mental health, and so forth. More work is needed to understand if discrepancies between PROMs and CROMs indicate poor validity of PROMs or 'valid' differences between patient and clinician perceptions. Our work suggests that single-item PROMs can be feasibly integrated into clinical settings.

Self-Reported Mental Health Measures of Incoming Collegiate Student-Athletes With a History of COVID-19.

People with a history of COVID-19 may experience persistent neuropsychological disruptions such as lower satisfaction with life, depression, and anxiety. Although student-athletes are at low risk for severe COVID-19 complications, the effect of COVID-19 on mental health has not been elucidated. To compare patient-reported mental health outcomes for incoming collegiate athletes with (COVID+) or without (COVID-) a history of COVID-19. Case-control study. Laboratory. A total of 178 student-athletes, consisting of 79 in the COVID+ group (44.3%; age = 18.90 ± 0.16 years) and 99 in the COVID- group (55.6%; age = 18.95 ± 0.16 years). Participants completed the Satisfaction With Life Scale (SWLS), the Hospital Anxiety and Depression Scale (HADS), and the State-Trait Anxiety Inventory (STAI). Unadjusted 1-way analyses of variance were conducted across all patient-reported outcomes. Analyses of covariance were calculated to determine the interaction of COVID-19 group, sex, and race and ethnicity on outcomes. Post hoc Bonferroni testing was performed to identify specific differences between groups. A χ2 analysis was computed to compare the number of athletes in each group who met the standard clinical cut points. We observed a between-groups difference for HADS depression (P = .047), whereby athletes in the COVID+ group had higher ratings (2.86 ± 0.26). We found group differences for the SWLS (P = .02), HADS anxiety (P = .003), and STAI state anxiety (P = .01) such that all scores were higher for the COVID+ group in the adjusted model. Post hoc testing revealed that female student-athletes in the COVID+ group had worse HADS anxiety (P = .01) and STAI trait anxiety (P = .002) scores than individuals in all other groups. We did not demonstrate differences between groups in the percentage of responses below established diagnostic thresholds. Incoming collegiate student-athletes who reported a previous COVID-19 diagnosis displayed higher depression scores, suggesting that clinicians may need to provide appropriate identification and referral for mental health conditions. However, we were encouraged that most participants, regardless of a history of COVID-19 diagnosis, had mental health scores that did not exceed established diagnostic threshold values.

Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial.

Depressive symptoms are highly prevalent and have broad-ranging negative implications. Digital interventions are increasingly available in the workplace context, but supporting evidence is limited. This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of 3 digital interventions for depressive symptoms in a sample of UK-based working adults experiencing mild to moderate symptoms. This was a parallel, multiarm, pilot randomized controlled trial. Participants were allocated to 1 of 3 digital interventions or a waitlist control group and had 3 weeks to complete 6 to 8 short self-guided sessions. The 3 interventions are available on the Unmind mental health app for working adults and draw on behavioral activation, cognitive behavioral therapy, and acceptance and commitment therapy. Web-based assessments were conducted at baseline, postintervention (week 3), and at 1-month follow-up (week 7). Participants were recruited via Prolific, a web-based recruitment platform, and the study was conducted entirely on the web. Feasibility and acceptability were assessed using objective engagement data and self-reported feedback. Efficacy outcomes were assessed using validated self-report measures of mental health and functioning and linear mixed models with intention-to-treat principles. In total, 2003 individuals were screened for participation, of which 20.22% (405/2003) were randomized. A total of 92% (373/405) of the participants were retained in the study, 97.4% (295/303) initiated their allocated intervention, and 66.3% (201/303) completed all sessions. Moreover, 80.6% (229/284) of the participants rated the quality of their allocated intervention as excellent or good, and 79.6% (226/284) of the participants were satisfied or very satisfied with their intervention. All active groups showed improvements in well-being, functioning, and depressive and anxiety symptoms compared with the control group, which were maintained at 4 weeks. Hedges g effect sizes for depressive symptoms ranged from -0.53 (95% CI -0.25 to -0.81) to -0.74 (95% CI -0.45 to -1.03). All interventions were feasible and acceptable, and the preliminary efficacy findings indicated that their use may improve depressive symptoms, well-being, and functioning. The predefined criteria for a definitive trial were met. International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN13067492; https://www.isrctn.com/ISRCTN13067492.

The Google Health Digital Well-Being Study: Protocol for a Digital Device Use and Well-Being Study.

The impact of digital device use on health and well-being is a pressing question. However, the scientific literature on this topic, to date, is marred by small and unrepresentative samples, poor measurement of core constructs, and a limited ability to address the psychological and behavioral mechanisms that may underlie the relationships between device use and well-being. Recent authoritative reviews have made urgent calls for future research projects to address these limitations. The critical role of research is to identify which patterns of use are associated with benefits versus risks and who is more vulnerable to harmful versus beneficial outcomes, so that we can pursue evidence-based product design, education, and regulation aimed at maximizing benefits and minimizing the risks of smartphones and other digital devices. The objective of this study is to provide normative data on objective patterns of smartphone use. We aim to (1) identify how patterns of smartphone use impact well-being and identify groups of individuals who show similar patterns of covariation between smartphone use and well-being measures across time; (2) examine sociodemographic and personality or mental health predictors and which patterns of smartphone use and well-being are associated with pre-post changes in mental health and functioning; (3) discover which nondevice behavior patterns mediate the association between device use and well-being; (4) identify and explore recruitment strategies to increase and improve the representation of traditionally underrepresented populations; and (5) provide a real-world baseline of observed stress, mood, insomnia, physical activity, and sleep across a representative population. This is a prospective, nonrandomized study to investigate the patterns and relationships among digital device use, sensor-based measures (including both behavioral and physiological signals), and self-reported measures of mental health and well-being. The study duration is 4 weeks per participant and includes passive sensing based on smartphone sensors, and optionally a wearable (Fitbit), for the complete study period. The smartphone device will provide activity, location, phone unlocks and app usage, and battery status information. At the time of submission, the study infrastructure and app have been designed and built, the institutional review board of the University of Oregon has approved the study protocol, and data collection is underway. Data from 4182 enrolled and consented participants have been collected as of March 27, 2023. We have made many efforts to sample a study population that matches the general population, and the demographic breakdown we have been able to achieve, to date, is not a perfect match. The impact of digital devices on mental health and well-being raises important questions. The Digital Well-Being Study is designed to help answer questions about the association between patterns of smartphone use and well-being. DERR1-10.2196/49189.

Trends in Language Use During the COVID-19 Pandemic and Relationship Between Language Use and Mental Health: Text Analysis Based on Free Responses From a Longitudinal Study.

The COVID-19 pandemic and its associated restrictions have been a major stressor that has exacerbated mental health worldwide. Qualitative data play a unique role in documenting mental states through both language features and content. Text analysis methods can provide insights into the associations between language use and mental health and reveal relevant themes that emerge organically in open-ended responses. The aim of this web-based longitudinal study on mental health during the early COVID-19 pandemic was to use text analysis methods to analyze free responses to the question, "Is there anything else you would like to tell us that might be important that we did not ask about?" Our goals were to determine whether individuals who responded to the item differed from nonresponders, to determine whether there were associations between language use and psychological status, and to characterize the content of responses and how responses changed over time. A total of 3655 individuals enrolled in the study were asked to complete self-reported measures of mental health and COVID-19 pandemic-related questions every 2 weeks for 6 months. Of these 3655 participants, 2497 (68.32%) provided at least 1 free response (9741 total responses). We used various text analysis methods to measure the links between language use and mental health and to characterize response themes over the first year of the pandemic. Response likelihood was influenced by demographic factors and health status: those who were male, Asian, Black, or Hispanic were less likely to respond, and the odds of responding increased with age and education as well as with a history of physical health conditions. Although mental health treatment history did not influence the overall likelihood of responding, it was associated with more negative sentiment, negative word use, and higher use of first-person singular pronouns. Responses were dynamically influenced by psychological status such that distress and loneliness were positively associated with an individual's likelihood to respond at a given time point and were associated with more negativity. Finally, the responses were negative in valence overall and exhibited fluctuations linked with external events. The responses covered a variety of topics, with the most common being mental health and emotion, social or physical distancing, and policy and government. Our results identify trends in language use during the first year of the pandemic and suggest that both the content of responses and overall sentiments are linked to mental health.

Screen time and adolescents' mental health before and after the COVID-19 lockdown in Switzerland: A natural experiment.

During the COVID-19 lockdown in 2020, adolescents' mental health was largely undermined. A general increment in screen time was reported. However, the long-term effects of the latter on adolescents' mental health are still little explored. In the present natural experiment, we investigated these effects using longitudinal data collected before and after the first lockdown in Switzerland. Data come from 674 Swiss adolescents (56.7% females, Mage = 14.45, SDage = 0.50) during Spring 2019 (T1) and Autumn 2020 (T2) as part of the longitudinal MEDIATICINO study. Self-reported mental health measures included somatic symptoms, inattention, anxiety, irritability, anger, sleep problems, obsessive-compulsive symptoms, loneliness, and depression. Measures for screen-media activities included time spent on the Internet, smartphones, social media, video gaming, instant messaging, and television viewing. They were all assessed at T1 and T2. Paired-sample t-tests with Bonferroni's correction showed that most mental health problems increased over time with an overall medium effect size (Hedge's g = 0.337). In particular, medium effect sizes were found for anxiety, depression, and inattention; small-to-medium effect sizes were reported for loneliness, sleep problems, and obsessive-compulsive symptoms; and a small effect size was found for somatic symptoms. Screen-media activities increased, with the exception of television viewing and video gaming. The results of the hierarchical regression analyses showed that, controlling for covariates, increased time spent on social media - calculated as the difference between T2 and T1 - was the only screen-media activity significantly associated with worse mental health at T2 (β = 0.112, p = 0.016). More time spent in structured media activities like television viewing diminished levels of inattention (β = -0.091, p = 0.021) and anxiety (β = -0.093, p = 0.014). Among covariates, being female, experiencing two or more life events, having mental health problems at T1, and using screens for homeschooling negatively influenced mental health at T2. These results align with literature indicating a small but negative effect of social media time on mental health. Underlying mechanisms are manifold, including increased exposure to COVID-19 news, heightened fear of missing out, social comparison, and time-displaced for activities such as physical activity and green time. However, in line with the structured days hypothesis, getting involved in media-structured activities like television viewing might protect against mental health symptoms.

Shared brain and genetic architectures between mental health and physical activity

Physical activity is correlated with, and effectively treats various forms of psychopathology. However, whether biological correlates of physical activity and psychopathology are shared remains unclear. Here, we examined the extent to which the neural and genetic architecture of physical activity and mental health are shared. Using data from the UK Biobank (N = 6389), we applied canonical correlation analysis to estimate associations between the amplitude and connectivity strength of subnetworks of three major neurocognitive networks (default mode, DMN; salience, SN; central executive networks, CEN) with accelerometer-derived measures of physical activity and self-reported mental health measures (primarily of depression, anxiety disorders, neuroticism, subjective well-being, and risk-taking behaviors). We estimated the genetic correlation between mental health and physical activity measures, as well as putative causal relationships by applying linkage disequilibrium score regression, genomic structural equational modeling, and latent causal variable analysis to genome-wide association summary statistics (GWAS N = 91,105–500,199). Physical activity and mental health were associated with connectivity strength and amplitude of the DMN, SN, and CEN (r’s ≥ 0.12, p’s < 0.048). These neural correlates exhibited highly similar loading patterns across mental health and physical activity models even when accounting for their shared variance. This suggests a largely shared brain network architecture between mental health and physical activity. Mental health and physical activity (including sleep) were also genetically correlated (|rg| = 0.085–0.121), but we found no evidence for causal relationships between them. Collectively, our findings provide empirical evidence that mental health and physical activity have shared brain and genetic architectures and suggest potential candidate subnetworks for future studies on brain mechanisms underlying beneficial effects of physical activity on mental health.

Building Emotional Awareness and Mental Health (BEAM): A Pilot Randomized Controlled Trial of an App-Based Program for Mothers of Toddlers.

BackgroundFamilies have faced unprecedented challenges during the COVID-19 pandemic, leading to increased maternal mental health problems and barriers to accessing care. Innovative programs are needed to support both maternal mental health and parenting, and to buffer the long-term impacts of stress on young children. Using a patient-oriented approach, our research team aimed to co-develop and pilot test an App-based psychoeducation and social-connection platform: Building Emotional Awareness and Mental Health (BEAM).MethodsThe co-development process involved a parent advisory board from conceptualization and design, through to direct participation in the program delivery. The BEAM program includes weekly videos and activities based on Unified Protocol therapy modules and emotion-focused parenting strategies, a weekly telehealth group review session, and access to a private online forum for support from other mothers and clinical coaches. A parallel randomized control trial was conducted across two provinces in Canada. Mothers of preschool children (aged 18–36 months old), with moderate-to-severe depression (Patient Health Questionaire-9 ≥ 10), were recruited online and randomized to either the 10-week BEAM intervention or treatment as usual (TAU) control group. Online surveys (ensuring researcher blinding) included questions about feasibility and acceptability of the program and pre/post self-report measures of mental health, parenting, positive coping and child behavior outcomes. The primary outcome measures were symptoms of depression and parenting stress. Data were analyzed using mixed models and an intention-to-treat approach.Results65 participants were randomized, by an online allocation tool, to the BEAM (n = 33) and TAU (n = 32) groups. Engagement was relatively high at the beginning of the program, with 78.8% starting the BEAM App and 70.6% attending ≥1 telehealth session. Most respondents felt socially supported, satisfied with the App, and found it easy to use. Pre-post results indicated interaction effects with greater reductions in overall mental health problems, and specifically anxiety and sleep symptoms, among BEAM vs. control participants. There were also time effects with reductions in depression symptoms across both groups. No significant treatment effects emerged for the other mental health symptoms, parenting problems, positive coping, or child behavior outcomes. Descriptive data are included to highlight possible areas of promise for future large efficacy trials. Technological difficulties and other challenges that may have led to attrition and impacted outcomes are discussed. There were no adverse events related to study participation.ConclusionsThe BEAM program has promise as a novel, feasible and acceptable intervention for improving mental health among mothers of young children.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT04772677].

Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat injury: analysis of baseline data from the ADVANCE cohort study

The long-term psychosocial outcomes of UK armed forces personnel who sustained serious combat injuries during deployment to Afghanistan are largely unknown. We aimed to assess rates of probable post-traumatic stress disorder (PTSD), depression, anxiety, and mental health-associated multimorbidity in a representative sample of serving and ex-serving UK military personnel with combat injuries, compared with rates in a matched sample of uninjured personnel. This analysis used baseline data from the ADVANCE cohort study, in which injured individuals were recruited from a sample of UK armed forces personnel who were deployed to Afghanistan and had physical combat injuries, according to records provided by the UK Ministry of Defence. Participants from the uninjured group were frequency-matched by age, rank, regiment, deployment, and role on deployment. Participants were recruited through postal, email, and telephone invitations. Participants completed a comprehensive health assessment, including physical health assessment and self-reported mental health measures (PTSD Checklist, Patient Health Questionnaire-9, and Generalised Anxiety Disorder-7). The mental health outcomes were rates of PTSD, depression, anxiety, and mental health-associated multimorbidity in the injured and uninjured groups. The ADVANCE study is ongoing and is registered with the ISRCTN registry, ISRCTN57285353. 579 combat-injured participants (161 with amputation injuries and 418 with non-amputation injuries) and 565 uninjured participants were included in the analysis. Participants had a median age of 33 years (IQR 30-37 years) at the time of assessment. 90·3% identified as White and 9·7% were from all other ethnic groups. The rates of PTSD (16·9% [n=89] vs 10·5% [n=53]; adjusted odds ratio [AOR] 1·67 [95% CI 1·16-2·41], depression (23·6% [n=129] vs 16·8% [n=87]; AOR 1·46 [1·08-2·03]), anxiety (20·8% [n=111] vs 13·5% [n=71]; AOR 1·56 [1·13-2·24]) and mental health-associated multimorbidity (15·3% [n=81] vs 9·8% [n=49]; AOR 1·62 [1·12-2·49]) were greater in the injured group than the uninjured group. Minimal differences in odds of reporting any poor mental health outcome were noted between the amputation injury subgroup and the uninjured group (AOR range 0·77-0·97), whereas up to double the odds were noted for the non-amputation injury subgroup compared with the uninjured group (AOR range 1·74-2·02). Serious physical combat injuries were associated with poor mental health outcomes. However, the type of injury sustained influenced this relationship. Regardless of injury, this cohort represents a group who present with greater rates of PTSD than the general population, as well as increased psychological burden from multimorbidity. The ADVANCE Charity.

Feasibility and Preliminary Efficacy of Web-Based and Mobile Interventions for Common Mental Health Problems in Working Adults: Multi-Arm Randomized Pilot Trial.

BackgroundThere is growing interest in digital platforms as a means of implementing scalable, accessible, and cost-effective mental health interventions in the workplace. However, little is known about the efficacy of such interventions when delivered to employee groups.ObjectiveThis study aims to evaluate the feasibility and preliminary efficacy of a digital mental health platform for the workplace, which incorporates evidence-based practices such as cognitive behavioral therapy and acceptance and commitment therapy. A total of 3 brief, unguided interventions designed to address stress, anxiety, and resilience, respectively, are evaluated. The primary aim is to determine the feasibility of the study methods and interventions in preparation for a definitive randomized controlled trial.MethodsThe study used a fully remote, parallel, multi-arm, external pilot randomized controlled trial, with 3 intervention arms and a no-intervention control group. Participants were working adults representative of the general UK population with respect to age, sex, and ethnicity who were recruited from a web-based participant platform. Primary outcomes included objective and self-report measures of feasibility, acceptability, engagement, transferability, relevance, and negative effects. Secondary outcomes included 4 self-report measures of mental health and well-being, completed at baseline (time point 0 [t0]), postintervention (time point 1 [t1]), and the 1-month follow-up (time point 2 [t2]). Secondary outcomes were analyzed via linear mixed-effects models using intention-to-treat principles. Preregistered criteria for progression to a definitive trial were evaluated.ResultsData were collected between January and March of 2021. A total of 383 working adult participants meeting trial eligibility were randomized, of whom 356 (93%) were retained at t2. Objective engagement data showed that 67.8% (196/289) of participants randomized to an intervention arm completed their intervention. Overall, 87.1% (203/233) of participants reported being satisfied or very satisfied with their intervention and rated the quality of their intervention as good or excellent. All intervention groups reported significantly greater improvements than the control group on at least one secondary outcome at t1, with between-group Hedges g effect sizes for the pooled interventions ranging from 0.25 (95% CI 0.05-0.46) to 0.43 (95% CI 0.23-0.64). All the improvements were maintained at t2.ConclusionsThe study methods were feasible, and all preregistered criteria for progression to a definitive trial were met. Several minor protocol amendments were noted. Preliminary efficacy findings suggest that the study interventions may result in improved mental health outcomes when offered to working adults.Trial RegistrationISRCTN Registry 80309011; http://www.isrctn.com/ISRCTN80309011

A group-based mental health intervention for Tanzanian youth living with HIV: Secondary analysis of a pilot trial.

Background:Youth living with human immunodeficiency virus (YLWH) are vulnerable to incomplete adherence to antiretroviral therapy in the context of stigma, decreased hope for future, and mental health challenges. Despite these challenges, few mental health interventions have been developed to support YLWH. Previous randomized results from the Sauti ya Vijana (SYV; “The Voice of Youth”) mental health intervention were indicative of the intervention's benefits in promoting virologic suppression.Methods:SYV is a group-based mental health and life skills intervention (pilot, individually randomized group treatment trial) developed alongside YLWH. SYV was comprised of 10, 90-minute sessions based on evidence-based treatment models designed to improve coping, social support, and hope for future as a pathway to improved adherence and virologic suppression. At baseline, YLWH 12 to 24 years of age were randomized to SYV or standard of care. Participants included in this secondary analysis were enrolled in SYV's crossover waves due to either being randomized to standard of care or inability to attend an earlier group, and therefore delayed intervention exposure. Measured outcomes included self-reported mental health measures, self-reported human immunodeficiency virus measures (stigma and adherence), and human immunodeficiency virus ribonucleic acid. Data was collected at baseline, preintervention, and postintervention timepoints. Participants were included if they attended a crossover wave and had data at all 3 timepoints.Results:Twenty-one crossover participants met inclusion criteria. Mean scores of self-reported mental health questionnaires were in an asymptomatic range both pre- and postintervention. Viral suppression was N = 15 (71%) preintervention compared to N = 17 (81%) postintervention. The participants who became virologically suppressed had no change in antiretroviral therapy.Conclusions:Despite the small sample size, findings from this study demonstrate that mental wellbeing may be an important pathway to improved HIV outcomes for YLWH. The same trend toward virologic suppression pre- to postintervention was demonstrated in the randomized pilot trial and suggests that SYV holds promise to improve HIV outcomes. Data from this analysis support the fully powered trial that is now underway.

Child and Parent Physical Activity, Sleep, and Screen Time During COVID-19 and Associations With Mental Health: Implications for Future Psycho-Cardiological Disease?

The COVID-19 pandemic has afforded the opportunity for some to improve lifestyle behaviours, while for others it has presented key challenges. Adverse changes in global lifestyle behaviours, including physical activity, sleep, and screen time can affect proximal mental health and in turn distal cardiovascular outcomes. We investigated differences in physical activity, sleep, and screen time in parents and children during early stages of the COVID-19 pandemic in Australia compared to pre-COVID-19 national data; and estimated associations between these movement behaviours with parent and child mental health. Cross-sectional baseline data from the COVID-19 Pandemic Adjustment Study (CPAS; N = 2,365) were compared to nationally representative pre-pandemic data from the Longitudinal Study of Australian Children (LSAC; N = 9,438). Participants were parents of children aged ≤ 18 years, residing in Australia. Parents provided self-report measures of mental health, physical activity and sleep quality, and reported on child mental health, physical activity and screen time. Children in CPAS had significantly more sleep problems and more weekend screen time. Their parents had significantly poorer sleep quality, despite increased weekly physical activity. Children's sleep problems were significantly associated with increased mental health problems, after accounting for socioeconomic status, physical activity, and screen time. Poorer parent sleep quality and lower levels of physical activity were significantly associated with poorer mental health. Monitoring this cohort over time will be important to examine whether changes in movement behaviour are enduring or naturally improve with the easing of restrictions; and whether these changes have lasting effects on either parent or child mental health, and in turn, future risk for CVD.

A cross-sectional study on impulsiveness, mindfulness, and World Health Organization quality of life in heartfulness meditators

Context: Heartfulness meditation (HM) is a heart-based meditation with its unique feature of transmitting energy which may have an impact on mental health and well-being. The present study intends to compare the mental health-related outcomes in long-term HM meditators (LTM), short-term HM meditators (STM), and control groups (CTL). Materials and Methods: The self-reported measures of mental health and well-being are reported by using State Trait Anxiety Inventory-II, Barratt Impulsive Scale-11, Mindfulness Attention Awareness Scale, Meditation Depth Questionnaire, and World Health Organization Quality of life-BREF. A total of 79 participants (29 females) participated in LTM (n = 28), STM (n = 26), and CTL (n = 25) with age range 30.09 ± 6.3 years. Results: The LTM and STM groups showed higher mindfulness along with the depth of meditation, quality of life, and lower anxiety and impulsivity than to CTL group. Our findings suggest that the HM practice enhances mindfulness, reduces anxiety, and regulates impulsivity. The LTM and STM groups showed significant positive trends of mindfulness as compared to CTL. Conclusion: The results indicated that HM practice could be an effective intervention for reducing anxious and impulsive behavior by subsequently improving mindfulness-related mental health and well-being.

Increased urban greenness associated with improved mental health among middle-aged and older adults of the Canadian Longitudinal Study on Aging (CLSA)

ObjectivesSome studies suggest that residential surrounding greenness is associated with improved mental health. Few of these studies have focussed on middle-aged and older adults, explored the modifying effects of social determinants of health, or accounted for the extent to which individuals interact with their neighbourhood environments. MethodsWe analysed cross-sectional data collected from 26,811 urban participants of the Canadian Longitudinal Study of Aging who were between 45 and 86 years of age. Participants provided details on socioeconomic characteristics, health behaviours, and their frequency of neighbourhood interactions. The Normalized Difference Vegetation Index (NDVI), a measure of greenness, was assigned to participants’ residential addresses at a buffer distance of 500 m. Four self-reported measures of mental health were considered: The Center for Epidemiologic Studies Depression Scale (CES-D-10; short scale), past diagnosis of clinical depression, perceptions of mental health, and the Satisfaction with Life Scale (SWLS). Regression models were used to describe associations between greenness and these outcomes, and spline models were fit to characterize the exposure-response function between greenness and CES-D-10 scores. Stratified analyses evaluated whether associations varied by sociodemographic status. ResultsIn adjusted models, we observed a 5% (Odds Ratio (OR) = 0.95; 95% CI = 0.90, 0.99) reduced odds of depressive symptoms in relation to an interquartile range increase of NDVI (0.06) within a 500 m buffer of the participant's residence. Similarly, we found an inverse association with a self-reported clinical diagnosis of depression (OR = 0.97; 95% CI = 0.92–1.01). Increases in surrounding greenness were associated with improved perceptions of mental health, and the SWLS. Our spline analyses found that beneficial effects between greenness and the CES-D-10 were strongest among those of lower income. ConclusionsThese findings suggest that residential greenness has mental health benefits, and that interventions to increase urban greenness can help reduce social inequalities in mental health.

Examining the association between subjective childbirth experience and maternal mental health at six months postpartum

ABSTRACT Problem Childbirth experience can have long-lasting effects on maternal wellbeing. Background Positive childbirth experiences may strengthen maternal self-confidence, in contrast, negativeexperiences may promote a sense of failure or distrust. Aim To examine the contribution of maternal hospital childbirth experience on mental health at 6 months postpartum in a community-based, Chilean sample. An additional aim is to examine which childbirth-related aspects contribute to the global birth experience. Methods One hundred and forty-eight women completed self-report measures of mental health during the third trimester of pregnancy and 3 and 6 months postpartum. At 3months after childbirth, subjective childbirth experience was assessed. Logistic regression analysis examined the contribution of childbirth experience to maternal mental health. Findings Negative subjective experience of childbirth contributes to maternal depression and anxiety up to 6 months after childbirth, controlling for mental health during pregnancy and at 3 months postpartum. Quality of care from health professionals made the largest, statistically significant contribution to the global perception of childbirth. Discussion and Conclusions Subjective experience of childbirth is a modifiable risk factor for the development of postpartum maternal depression and anxiety. Health providers in direct contact with childbearing women may promote maternal emotional wellbeing through sensitive and respectful care.