Subjective Mental Health Research Articles

Environmental barriers and subjective health among people with chronic spinal cord injury: A cohort study

ObjectiveAlthough previous studies have found environmental barriers to be associated with social participation and life satisfaction after spinal cord injury (SCI), few studies exist reporting their effects on subjective health after SCI. Our purpose was to identify the prevalence of perceived environmental barriers and their effects on subjective health in persons with chronic SCI who completed two repeated measurements during a 5-year longitudinal study.DesignThis is a prospective cohort study. Environmental barriers were measured at baseline by the Craig Hospital Inventory of Environmental Factors-Short Form. Subjective health was measured at baseline and 5-year follow-up by days of physical and mental health not good. Other control variables included sex, race, age at injury, years since injury, and injury severity at baseline.SettingData were collected at a specialty hospital and analyzed at a medical university in the Southeastern USA.ParticipantsA total of 1635 participants completed both baseline and follow-up surveys.ResultsTwenty per cent of participants reported at least one policy barrier, 46% at least one physical and structural barrier, 22% at least one attitudinal and support barrier, 26% at least one barrier to services and assistance, and 13% at least one barrier at work or school. After controlling for sex, race, age at injury, years since injury, and injury severity, the physical and structural barriers, and services and assistance barriers measured at baseline significantly predicted subjective physical and mental health measured at follow-up.ConclusionEnvironmental barriers are prevalent among people with chronic SCI. They are important predictors for future subjective health.

Long-term mental health outcome in post-conflict settings: Similarities and differences between Kosovo and Rwanda.

Few studies investigated the long-term mental health outcome in culturally different post-conflict settings. This study considers two surveys conducted in Kosovo 8 years after the Balkans war and in Rwanda 14 years after the genocide. All participants (n = 864 in Kosovo; n = 962 in Rwanda) were interviewed using the posttraumatic stress disorder (PTSD) and major depressive episode (MDE) sections of the Mini International Neuropsychiatric Interview (MINI) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Proportions of participants who met diagnostic criteria for either PTSD or MDE were 33.0% in Kosovo and 31.0% in Rwanda, with co-occurrence of both disorders in 17.8% of the Rwandan sample and 9.5% of the Kosovan sample. Among patients with PTSD, patterns of symptoms significantly differed in the two settings, with avoidance and inability to recall less frequent and sense of a foreshortened future and increased startle response more common in Rwanda. Significant differences were also observed in patients with MDE, with loss of energy and difficulties concentrating less frequent and suicidal ideation more common in Rwanda. Comorbid PTSD and MDE were associated with decreased SF-36 subjective mental and physical health scores in both settings, but significantly larger effects in Kosovo than in Rwanda. Culturally different civilian populations exposed to mass trauma may differ with respect to their long-term mental health outcome, including comorbidity, symptom profile and health perception.

Predictors of Well-being Among Older Gays and Lesbians

This study aims to examine the predictors of subjective well-being in older gays and lesbians across multiple domains including health, function, personality, and socio-environmental factors. Participants were 209 community-dwelling gays and lesbians ages 56–80 residing in Israel. Structured questionnaires were completed. Assessments included subjective well-being, hope, physical and mental health, participation, activities of daily living (ADL), Instrumental ADLs, environment and living conditions, and accessibility and availability of community services. Physical and mental health, hope, and community availability and accessibility were significant predictors of subjective well-being in the fully adjusted model. Environmental factors were secondary in their predictive ability. Findings are novel in elucidating the contribution of health, hope, and communal services to the well-being of older gays and lesbians. Hope may mediate the relationship between well-being, and social participation and environment and living conditions in this population. Implications include the promotion of health monitoring and provision services, and tackling mental health difficulties via interventions that aim to enhance one’s sense of agency and goal achievement. Another avenue for enhancing older gays and lesbians’ agency and well-being may involve strengthening their communal and environmental resources in their place of residency.

Psychological and Work Stress Assessment of Patients following Angioplasty or Heart Surgery: Results of 1‐year Follow‐up Study

The aim of this study was to explore changes in subjective psychological health and perceived work stress among patients who returned to work (RTW) after a multidisciplinary cardiac rehabilitation (CR) following cardiac interventions. A total of 108 patients were evaluated at the beginning of their CR, at 6 and 12 months after discharge. Self-report questionnaires were used to assess depression, anxiety, illness perception and work stress at each time stage. Results showed reports of depressive symptoms significantly decreased (p < 0.05) and subjective mental (p = 0.001) and physical health (p < 0.001) improved over time. Patients revealed a decrease in Type A behaviour pattern (p < 0.001) and in job satisfaction levels (p = 0.01), greater internal locus of control (p < 0.01) and increased use of the coping strategy 'Involvement' (p < 0.01). Major findings are that cardiac patients had an improvement in subjective psychological health and did not perceive increased work stress after their RTW. Patients' psychological health and work stress need to be assessed during the CR and should be also carefully monitored after the RTW in order to identify patients' psychological and work-related barriers and facilitate a safe and successful work reintegration.

Racial/Ethnic Identity and Subjective Physical and Mental Health of Latino Americans: An Asset Within?

Social Identity Theory indicates that ethnic identity could benefit minority members in a society because of its promotion of a sense of belonging, or of its buffering of the damage of discrimination. Despite growing investigation about Latinos' overall health, few studies have simultaneously examined the influence of multiple cultural strength factors, especially racial/ethnic identity, social support, and religious attendance, on these outcomes. Using the National Latino and Asian American Study, we examine the potential predictive value of these cultural strength factors on Latinos' Self-Rated Mental and Physical Health (SRMH and SRPH). Two separate two-step regression models revealed significant positive effects of racial/ethnic identity on both mental and physical health of Latinos, above and beyond the effect of known demographic and acculturation factors, such as discrimination. Religious attendance had a positive effect on SRMH but not on SRPH. The deteriorating roles of discrimination, in mental health only, and that of Length in the US in both outcomes, however, was primarily not altered by entry of these cultural strength factors. The independent direct effect of racial/ethnic identity among Latinos nationwide may suggest that this cultural strength is an internalized protective asset. Longitudinal data is needed to explore its underlying mechanism and long-term impact.

The Long-Run Consequences of Chernobyl: Evidence on Subjective Well-Being, Mental Health and Welfare

The Long-Run Consequences of Chernobyl: Evidence on Subjective Well-Being, Mental Health and Welfare

Comparative Study on Health Promoting Behavior in Working and Non-working Mothers with Infants and Toddlers

Purpose: The purpose of this study was to compare health promoting behavior between working and non-working mothers with infants and toddlers, and to investigate factors affecting the mothers’health promoting behavior. Methods: This descriptive study was conducted through conveniently sampled 403 women who visited the child health clinics at two public health centers. The questionnaire included the Health Promoting Life Style Profile (HPLP) and a visual analogue scale for subjective health status. ANCOVA, one-way ANOVA, correlation analysis, and stepwise multiple regression were conducted using SPSS ver. 21. Results: Working mothers’ average HPLP score (2.30±0.37) was higher than non-working mother’s (2.15±0.37). The score of the physical activity subscale was lowest among the subscales and there was a difference between the two groups. Subjective mental health status was the only predictor of working mothers’health promoting behavior, and it explained 23.2% of variance in health promoting behavior. Subjective mental health status, education, and age were the predictors of non-working mothers’ health promoting behavior and they explained 27.2% of variance in health promoting behavior. Conclusion: According to the findings, both working and non-working mothers’ health promoting behaviors were low. To promote mothers’ health, it is necessary to develop diverse community health promotion programs to support mothers.

Selected family characteristics are associated with adolescents' subjective health complaints

This national study of schoolchildren in Greece investigated the association between adolescents' subjective health complaints (SHC) and a number of family characteristics. Questionnaires were completed by a random, school-based sample of children from 12 to 18 years of age, and one of their parents (76.6% mothers), in 2003. Data from 1041 adolescent-parent pairs were analysed. Multiple linear regression analysis was used to assess the associations between the adolescent's SHC and the following characteristics: parent's marital status, parent's physical and mental health status, parent's worries about their child's SHC, the parent-child relationship, family cohesion, family socio-economic status and the adolescent's sex and age. The analysis showed that the adolescents' SHC were independently and significantly correlated with poor parental subjective mental health status, poor quality parent-child relationships and parental worry. There were also associations between levels of SHC and female and older adolescents. Certain family features can be seen as potential contributing factors to SHC in adolescence and should therefore constitute complementary targets for prevention and treatment planning.

Preliminary investigation into subjective well-being, mental health, resilience, and spinal cord injury

ObjectivesTo undertake a pilot investigation into whether individuals whose subjective well-being had returned to the normal homeostatic range after a spinal cord injury (SCI) may be more resilient and therefore, at less risk of emotional distress over time. To consider the relative stability of subjective well-being in individuals with chronic SCI whose subjective well-being had previously returned to the normative homeostatic range.Study designLongitudinal study: Time 1 (T1) 2004 and Time 2 (T2) 2009.SettingVictoria, Australia.ParticipantsParticipants were adults living in the community with chronic SCI, who had no mental ill-health symptoms at T1.Outcome measuresScales include: Comprehensive Quality of Life Scale – Adult v5 (COMQoL-A5) at T1, Personal Well-being Index (PWI – the successor to the COMQol-A5) at T2, and Depression, Anxiety & Stress Scale – short form (DASS-21) at T1 and T2.ResultsTwenty-one adults participated at T1 and T2. Subjective well-being was stable for 57% of the cohort. However, 19% presented with symptoms of emotional distress by T2. There was no significant difference in age (P = 0.94) or time since injury (P = 0.51) between those reporting significant emotional symptoms and those without; nor was there any systematic change in health status.ConclusionThis study yielded two important findings. First, individuals with chronic SCI may be vulnerable to mental health issues even after they have previously exhibited good resilience. Second, subjective well-being after SCI may not be as stable as suggested by the general quality of life literature that have examined genetic and personality connections to subjective well-being.

Cyberstalking in a Large Sample of Social Network Users: Prevalence, Characteristics, and Impact Upon Victims

The aim of this study was to determine the prevalence of cyberstalking victimization, characteristics of victims and offenders, and the impact of cyberstalking on the victims' well-being and mental health. An online survey of 6,379 participants was carried out, involving users of the German social network StudiVZ. Subjective mental health status was assessed with the WHO-5 well-being index. The prevalence of cyberstalking was estimated at 6.3%. In various aspects, cyberstalking was comparable to offline stalking: cyberstalking occurred most often in the context of ex-partner relationships; most of the victims were female and the majority of the perpetrators were male. Compared to non-victims, victims of cyberstalking scored significantly poorer on the WHO-5 well-being index. The prevalence of cyberstalking is considerable. However, if stringent definition criteria comparable to those of offline stalking are applied, it is not a mass phenomenon. The negative impact of cyberstalking on the victims' well-being appears similar to that of offline stalking. Hence, cyberstalking should be taken as seriously as offline variants of stalking by legal authorities and victim assistance professionals.

Burden and Support Needs of Carers of Persons with Borderline Personality Disorder

A major feature of personality disorders is significant impairment in interpersonal functioning, which may create challenges in close relationships. This article aims to systematically review the experience of carers of persons with personality disorders. The PRISMA systematic review method was followed, and empirical studies written in English, published between 1996 and 2011, and cited in major electronic databases were searched. Studies meeting the following selection criteria were included: (1) carers or families of persons with personality disorders; (2) intervention involving the carers or families; (3) burden or related construct used. Studies were required to meet either criteria 1 and 3 or criteria 2 and 3. Reference lists were scanned, and experts were consulted for further studies. Six studies met inclusion criteria, representing data on 465 carers. Five of the six studies focused on carers of persons with borderline personality disorder. The findings indicated that carers experience elevated objective and subjective burden, grief, impaired empowerment, and mental health problems, including depression and anxiety. Scores on objective and subjective burden were half a standard deviation above the mean compared to carers of inpatients with other serious mental illnesses. This study is the first to report data on a large, aggregated sample of carers of persons with personality disorders. Significant gaps in the literature remain, and it is recommended that future research focus on the burden and support needs of carers of persons across different personality disorders, that attention be paid to the gender balance of patients, and that data be reported in a way to allow meta-analysis.

Trajectories and personality correlates of change in perceptions of physical and mental health across adulthood and old age

Subjective health is known to predict later outcomes, including survival. However, less is known about subjective health changes across adulthood, how personality moderates those changes, and whether such associations differ with age. We applied growth models to 10 waves of data from the Household, Income and Labour Dynamics in Australia Survey (HILDA, N = 7,172; median ages 20–93) to examine age-related differences in trajectories of subjective physical and mental health. On average, perceptions of physical health declined with increasing steepness in old age, whereas self-rated mental health remained relatively stable across all ages. Higher neuroticism and lower extraversion and conscientiousness were each related to less successful aging. The health implications of personality did not differ by age for physical health, but were weaker for mental health in old age. We discuss implications of our results for accelerated longitudinal designs and consider avenues for future more mechanism-oriented research.

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking

Aims. To examine stigma- and knowledge-related barriers to help-seeking among members of the general population. Methods. In a representative survey of young to middle-aged Swiss adults (n=8875), shame about a potential own mental illness, perceived knowledge about and satisfaction with one's mental health, psychiatric symptoms and attitudes towards help-seeking were assessed. Results. A latent profile analysis of all participants yielded two groups with different attitudes towards help-seeking. Relative to the majority, a one-in-four subgroup endorsed more negative attitudes towards seeking professional help, including psychiatric medication, and was characterized by more shame, less perceived knowledge, higher satisfaction with their mental health, younger age, male gender and lower education. Among participants with high symptom levels (n=855), a third subgroup was reluctant to seek help in their private environment and characterized by high symptoms as well as low satisfaction with their mental health. Conclusions. Shame as an emotional proxy of self-stigma as well as poor subjective mental health literacy may be independent barriers to help-seeking. Interventions to increase mental health service use could focus on both variables and on those individuals with more negative views about professional help, in the general public as well as among people with a current mental illness.

Participation in a 10-week course of yoga improves behavioural control and decreases psychological distress in a prison population

BackgroundYoga and meditation have been shown to be effective in alleviating symptoms of depression and anxiety in healthy volunteers and psychiatric populations. Recent work has also indicated that yoga can improve cognitive-behavioural performance and control. Although there have been no controlled studies of the effects of yoga in a prison population, we reasoned that yoga could have beneficial effects in a setting where psychosocial functioning is often low, and the frequency of impulsive behaviours is high. MethodsParticipants were recruited from 7 British prisons and randomly allocated to either a 10-week yoga programme (yoga group; 1 class per week; N = 45) or a control group (N = 55). Self-report measures of mood, stress, and psychological distress were collected before and after the intervention period. Participants completed a cognitive-behavioural task (Go/No-Go) at the end of the study, which assessed behavioural response inhibition and sustained attention. ResultsParticipants in the yoga group showed increased self-reported positive affect, and reduced stress and psychological distress, compared to participants in the control group. Participants who completed the yoga course also showed better performance in the cognitive-behavioural task, making significantly fewer errors of omission in Go trials and fewer errors of commission on No-Go trials, compared to control participants. ConclusionsYoga may be effective in improving subjective wellbeing, mental health, and executive functioning within prison populations. This is an important consideration given the consistently high rates of psychological morbidity in this group and the need for effective and economical intervention programmes.

Loneliness and social support of older people in China: a systematic literature review

Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources.

Health-related quality of life, ethnicity and perceived discrimination among immigrants and natives in Spain

ObjectivesThe current study compares subjective mental and physical health among native Spaniards and immigrant groups, and examines the effects of ethnicity and perceived discrimination (PD) on subjective health in immigrants.DesignTwo random samples of 1250 immigrants to Spain from Colombia, Bolivia, Romania, Morocco, and Sub-Saharan Africa and 500 native Spaniards, aged between 18 and 65, were recruited for this cross-sectional study. Several hierarchical regression analyses of ethnicity and PD on subjective mental and physical health (assessed using the health-related quality of life items, HRQLSF-12) were carried out separately for men and women.ResultsMale immigrants from Colombia and Sub-Saharan Africa showed better physical health than natives, controlling for age and socioeconomic and marital status. The immigrants – except for the Colombians – had poorer mental health than natives, especially African men and Bolivian women. Socioeconomic status had no impact on these differences. Among immigrants, PD was the best predictor of physical and mental health (controlling for socio-demographic variables). African men, Bolivian women and women without legal status exhibited the poorest self-rated mental health.ConclusionClear differences in health status among natives and immigrants were recorded. The self-selection hypothesis was plausible for physical health of Colombians and Sub-Saharan African men. Acculturation stress could explain poorer mental health in immigrants compared with natives. The association between ethnicity and poor self-reported mental health appears to be partially mediated by discrimination.

Association of Subjective and Objective Socioeconomic Status with Subjective Mental Health and Mental Disorders Among Japanese Men and Women

An inverse association between socioeconomic status (SES) and mental health has been previously well reported, but the evidence is limited in Asian populations. We therefore investigated the association of SES and subjective mental health and prevalence of any mental disorders in the general population of Japan. We used data from the World Mental Health Japan Survey of 1,496 randomly selected people aged 20 years and older in Japan. Information on education level and household income were used as objective SES indicators, and subjective social status (SSS) was measured by responses to a question regarding social position. We calculated odds ratios of SES indicators for poor subjective mental health and 12-month prevalence of any mental disorders. The adjusted odds ratio (OR) (95 % confidence interval (CI)) of respondents who rated themselves as lower than middle status in the country (low SSS group) for poor subjective mental health was 2.24 (95 % CI: 1.41, 3.57) with reference to those who rated themselves as higher than middle status (high SSS group). Similarly, inverse associations of education level and household income with poor subjective mental health were identified. A J-shaped association was confirmed between SSS and 12-month prevalence of any mental disorders. The adjusted OR (95 % CI) of SSS for any mental diseases was 0.53 (95 % CI: 0.32, 0.86) for the middle SSS group and 1.61 (95 % CI: 0.96, 2.72) for the low SSS group, compared with the high SSS group. Those associations were not attenuated when objective SES indicators were adjusted. We found inversely linear associations between subjective and objective SES and poor subjective mental health among Japanese men and women. SSS was not significantly associated with 12-month prevalence of any mental disorders. Substantial social inequalities in mental health were identified in Japan, which has been considered an egalitarian society with relatively few inequalities in health.

Predictors of Criminal Justice Outcomes Among Mental Health Courts Participants: The Role of Perceived Coercion and Subjective Mental Health Recovery

Internationally, one effort to reduce the number of people with serious mental illness (SMI) in jails and prisons is the development of Mental Health Courts (MHC). Research on MHCs to date has been disproportionately focused on the study of recidivism and re-incarceration over the potential of these problem-solving courts to facilitate mental health recovery and affect the slope or gradient of opportunity for recovery. Despite the strong conceptual links between the MHC approach and the recovery-orientation in mental health, the capacity for MHCs to facilitate recovery has not been explored. This user-informed mental health and criminal justice (MH/CJ) community-based participatory (CBPR) study assesses the extent to which MHC practices align with recovery-oriented principles and may subsequently affect criminal justice outcomes. We report on the experiences and perceptions of 51 MHC participants across four metropolitan Mental Health Courts. Specifically, the current study assesses: (1) how defendants’ perceptions of court practices, particularly with regard to procedural justice and coercion, relate to perceptions of mental health recovery and psychiatric symptoms, and, (2) how perceptions of procedural justice and mental health recovery relate to subsequent criminal justice outcomes. The authors hypothesized that perceived coercion and mental health recovery would be inversely related, that perceived coercion would be associated with worse criminal justice outcomes, and perceptions of mental health recovery would be associated with better criminal justice outcomes. Results suggest that perceived coercion in the MHC experience was negatively associated with perceptions of recovery among MHC participants. Perceptions of “negative pressures,” a component of coercion, were important predictors of criminal justice involvement in the 12-month period following MHC admission, even when controlling for other factors that were related to criminal justice outcomes, and that an increase in procedural justice was associated with a decrease in symptoms but curiously not to an increase in attitudes toward recovery. Implications and future directions are discussed.

중학교 학생들의 자살에 대한 인식도 조사

Objectives : The aim of this study was to examine attitudes of middle-school students toward happiness, suicide, and factors associated with suicide. Methods : A self-administered questionnaire was used in a cluster sample of 1,319 middle-school students (male 793, female 526). Data were obtained on a wide range of constructs regarding their attitude towards happiness, suicidal ideation and attempts, and factors associated with suicide. Results : Middle-school students choose 'love within family' as most important factor for their happiness. Subjective mental health status was mostly associated with happiness. Subjects in lower socioeconomic status tended to respond their mental health status was not good and have more suicidal idea. 48.7% of subjects had permissive attitudes toward suicide, especially, girls. However, 65.0% responded that suicide was preventable problem. Compared to older people, middle-school students perceived that environmental factors were more important than innate and personal factors for suicide. Conclusion : Results of the study indicate that middle-school students have permissive attitudes toward suicide, but positive attitudes for the prevention of suicide. This suggest that education in these age group could be effective for the prevention of suicide. Also, approaches to suicide prevention programs should be developed based on the family intervention. Especially, we should care about girls and adolescents in lower socioeconomic status.

Neurocognitive, Mental Health, and Glucose Disorders in Farmers Exposed to Organophosphorus Pesticides

About 25 million agricultural workers in the developing world suffer from at least one episode of poisoning each year, mainly by anticholinesterase-like organophosphates (OPs). The objective of this cross-sectional study was to establish the OP toxicity in 187 occupationally exposed farmers in terms of neurocognitive impairment, mental health status, clinical symptoms, diabetes, and haematological factors. The exposed group was compared to 187 healthy age-, sex-, and education-matching controls. Neurocognitive impairment was measured using the Subjective Neurocognition Inventory (SNI) and mental health status using the General Health Questionnaire-28 (GHQ-28). The subjects were also tested for fasting blood glucose (FBG), blood urea nitrogen (BUN), cholesterol (CL), triglycerides (TG), creatinine, oral glucose tolerance test (GTT), high-density lipoprotein (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP). The exposed farmers showed higher FBG (p<0.001), BUN (p=0.007), CL (p<0.001), oral GTT (p<0.001), and lower AST (p<0.001), ALP (p<0.001), and creatinine (p=0.004) than controls. The rates of anxiety/ insomnia and severe depression were also significantly higher in the farmers than in controls (p=0.015 and p<0.001, respectively). Meanwhile, the rate of social dysfunction was significantly lower than in controls (p<0.001). Disorders affecting psychomotor speed, selective attention, divided attention, verbal memory, nonverbal memory, prospective memory, spatial functioning, and initiative/energy were all lower in the farmers (p<0.001). Farmers showed clinical symptoms eczema, saliva secretion, fatigue, headache, sweating, abdominal pain, nausea, superior distal muscle weakness, inferior distal muscle weakness, inferior proximal muscle weakness, breath muscle weakness, hand tingling, foot tingling, epiphoria, polyuria, miosis, dyspnoea, bradycardia, and rhinorrhoea, which all significantly correlated with the number of working years. These findings indicate that farmers who work with OPs are prone to neuropsychological disorders and diabetes.