Subsequent Mental Health Research Articles

Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study-Part of PROPOLIS Study).

Background: Stroke patients are particularly vulnerable to delirium episodes, but very little is known about its subsequent adverse mental health outcomes. The author’s objective was to explore the association between in-hospital delirium and depression, anxiety, anger and apathy after stroke. Methods: A total of 750 consecutive patients with acute stroke or transient ischemic attack, were screened for delirium during hospitalization. Patients underwent mental health evaluation in hospital, 3 and 12 months post-stroke; depression, apathy, anxiety and anger were the outcomes measured at all evaluation check points. Results: Delirium was an independent risk factor for depression (OR = 2.28, 95%CI 1.15–4.51, p = 0.017) and aggression (OR = 3.39, 95%CI 1.48–7.73, p = 0.004) at the hospital, for anxiety 3 months post-stroke (OR = 2.83, 95%CI 1.25–6.39, p = 0.012), and for apathy at the hospital (OR = 4.82, 95%CI 2.25–10.47, p < 0.001), after 3 (OR = 3.84, 95%CI 1.31–11.21, p = 0.014) and 12 months (OR = 4.95, 95%CI 1.68–14.54, p = 0.004) post stroke. Conclusions: The results of this study confirm, that mental health problems are very frequent complications of stroke. Delirium in the acute phase of stroke influences mental health of patients. This effect is especially significant in the first months post-stroke and vanishes with time, which suggests that in-hospital delirium might not be a damaging occurrence in most measures of mental health problems from a long-term perspective.

Spiritually Motivated Self-Forgiveness and Divine Forgiveness, and Subsequent Health and Well-Being Among Middle-Aged Female Nurses: An Outcome-Wide Longitudinal Approach.

Background: Interest in the relationship between forgiveness and health is steadily growing across disciplines within the research community. While there are multiple forms of forgiveness, past research has focused principally on studying forgiveness of others, whereas longitudinal evidence on the associations between other forms of forgiveness and health remains scarce.Methods: Using longitudinal data from the Nurses’ Health Study II (from the 2008 Trauma Exposure and Post-traumatic Stress Supplementary Survey to 2015 questionnaire wave), this study employed an outcome-wide analytic approach to prospectively examine the association between two forms of religiously or spiritually motivated forgiveness, namely, self-forgiveness and divine forgiveness, and a wide array of subsequent psychosocial well-being, mental health, health behavior, and physical health outcomes among middle-aged female nurses (N = 54,703 for self-forgiveness; N = 51,661 for divine forgiveness). All models controlled for sociodemographic factors, prior religious service attendance, and prior values of all outcome variables wherever data were available. Bonferroni correction was used to account for multiple testing.Results: Self-forgiveness was strongly associated with greater psychosocial well-being (e.g., for top vs. bottom level of self-forgiveness, β = 0.23, 95% CI: 0.20, 0.25 for positive affect) and lower psychological distress (e.g., β = −0.21, 95% CI: −0.23, −0.18 for depressive symptoms). To a lesser extent, divine forgiveness was also associated with higher levels of psychological well-being and lower psychological distress. For both forgiveness types, there was little evidence of association with physical health or health behavior outcomes, though possible marginal evidence for an association of self-forgiveness with increased mortality.Discussion: This study provides novel evidence that religiously or spiritually motivated self-forgiveness and divine forgiveness are both positively related to several indicators of psychosocial well-being and inversely associated with psychological distress outcomes, whereas the associations with physical health and health behaviors are less clear. Further longitudinal investigation of the dynamics between these types of forgiveness and health and well-being is warranted.

HIV Stigma and Its Associations with Longitudinal Health Outcomes Among Persons Living with HIV with a History of Unhealthy Alcohol Use.

This study examined the demographic and clinical correlates of HIV stigma and evaluated how HIV stigma was associated with physical and mental health outcomes one year later in a primary-care based cohort of persons living with HIV (PLHIV; N = 584). HIV stigma was measured using a modified Berger HIV stigma scale, which includes four subscales: (1) personalized stigma; (2) disclosure concerns; (3) negative self-image; and (4) concerns around public attitudes towards PLHIV. Physical and mental health were assessed using the 12-item short form survey (SF-12). Compared to whites, African Americans were more likely to have higher personalized stigma scores (adjusted prevalence ratio [aPR] 1.54 [95% confidence interval 1.10-2.15]), disclosure concerns (aPR 1.40 [1.03-1.92]), and concerns with public attitudes about PLHIV (aPR 1.61 [1.11-2.34]). Hispanic/Latinx participants were more likely to have concerns around public attitudes towards PLHIV (aPR 1.50 [1.11-2.02]) than whites. Compared to men, women were more likely to have higher negative self-image scores (aPR 1.50 [1.08-2.08]). Higher stigma scores were associated with poorer subsequent self-reported physical and mental health functional status. Our findings highlight the substantial need for addressing HIV stigma, particularly among minority subgroups.

Health behaviour changes during COVID-19 and the potential consequences: A mini-review.

The COVID-19 pandemic has brought about profound changes to social behaviour. While calls to identify mental health effects that may stem from these changes should be heeded, there is also a need to examine potential changes with respect to health behaviours. Media reports have signalled dramatic shifts in sleep, substance use, physical activity and diet, which may have subsequent downstream mental health consequences. We briefly discuss the interplay between health behaviours and mental health, and the possible changes in these areas resulting from anti-pandemic measures. We also highlight a call for greater research efforts to address the short and long-term consequences of changes to health behaviours.

ED Visits and Readmissions After Follow-up for Mental Health Hospitalization

A national quality measure in the Child Core Set is used to assess whether pediatric patients hospitalized for a mental illness receive timely follow-up care. In this study, we examine the relationship between adherence to the quality measure and repeat use of the emergency department (ED) or repeat hospitalization for a primary mental health condition. We used the Truven MarketScan Medicaid Database 2015-2016, identifying hospitalizations with a primary diagnosis of depression, bipolar disorder, psychosis, or anxiety for patients aged 6 to 17 years. Primary predictors were outpatient follow-up visits within 7 and 30 days. The primary outcome was time to subsequent mental health-related ED visit or hospitalization. We conducted bivariate and multivariate analyses using Cox proportional hazard models to assess relationships between predictors and outcome. Of 22 844 hospitalizations, 62.0% had 7-day follow-up, and 82.3% had 30-day follow-up. Subsequent acute use was common, with 22.4% having an ED or hospital admission within 30 days and 54.8% within 6 months. Decreased likelihood of follow-up was associated with non-Hispanic or non-Latino black race and/or ethnicity, fee-for-service insurance, having no comorbidities, discharge from a medical or surgical unit, and suicide attempt. Timely outpatient follow-up was associated with increased subsequent acute care use (hazard ratio [95% confidence interval]: 7 days: 1.20 [1.16-1.25]; 30 days: 1.31 [1.25-1.37]). These associations remained after adjusting for severity indicators. Although more than half of patients received follow-up within 7 days, variations across patient population suggest that care improvements are needed. The increased hazard of subsequent use indicates the complexity of treating these patients and points to potential opportunities to intervene at follow-up visits.

Pre-Employment MMPI-2 Measures and Later Psychological Injury-Related Absenteeism among Police Officers

Abstract Pre-employment screening to assess for psychological vulnerability is common in trauma-exposed occupations such as policing. However, the ability of such screening to predict those at increased risk of subsequent mental health problems has been questioned. The present study sought to investigate the ability of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) to predict absenteeism related to psychological injury in police officers. Pre-employment screening data from 1,399 sworn police officers was linked to organizational records. A total of 150 police officers who had taken at least 2 weeks’ sick leave with work-related mental health concerns were matched to 150 healthy controls. Conditional logistic regression was used to examine any association between MMPI-2 scales and psychological injury-related absenteeism. We found no evidence that elevations in the pre-employment MMPI-2 scores of police recruits were associated with an increased chance of future absenteeism as a result of psychological injury (P &amp;gt; 0.05). In addition, there was no evidence of an increased likelihood of psychological injury-related absenteeism among those with a higher number of positive pre-employment risk factors (P = 0.09). While the MMPI-2 may be able to predict different outcomes among police officers, it is important to note that based on these results, the MMPI-2, if used at pre-employment, is not able to predict later psychological injury-related absenteeism.

School-Based Prevention Targeting Non-Suicidal Self-injury: A Pilot Study.

Non-suicidal self-injury (NSSI) is prevalent in adolescence and is associated with increased risk for a variety of subsequent negative mental health outcomes, necessitating an evidence-based preventive approach. This pilot study examines the potential iatrogenic effects and feasibility of an evidence-based school program for the prevention of NSSI. Differences are examined between a general in-classroom prevention program (Happyles) and this program combined with a 1-h in-classroom psychoeducation module on NSSI (HappylesPLUS) in terms of primary (e.g., delay in NSSI onset and decrease in NSSI frequency, urges, probability of future engagement) and secondary outcomes (e.g., psychological distress, emotion regulation, help-seeking, and stigma) using a mixed-method design. A total of 651 secundary school pupils (Mage = 12.85 years; 49.8% female versus 50.2% male) were assigned to the Happyles program and HappylesPLUS. Participants filled out validated self-report questionnaires pre (T0) and post (T1, 6 weeks after T0) the school prevention program, including the Youth Outcome Questionnaire (YOQ), the Brief Non-Suicidal Self-Injury Assessment Test (BNSSI-AT), the Difficulties in Emotion Regulation Scale (DERS), the Attitudes Toward Seeking Professional Psychological Help Scale—Short Form (ATSPPH-SF), and the Peer Mental Health Stigmatization Scale (PMHSS). Qualitative semi-structured interviews (at T2,6 weeks after T1) were conducted with participants with and without a history of NSSI. Overall, results show no iatrogenic effects of the NSSI-focused psychoeducation module. In terms of our primary outcome, both groups reported a reduced likelihood of future NSSI engagement from T0 to T1. Regarding secondary outcome measures, we also observed increased emotional awareness in both groups. The qualitative data suggest that the addition of the NSSI-specific module to the Happyles program may have direct benefits to some students with lived experience, such as increased help-seeking behavior for NSSI. Findings of this pilot study show that incorporating NSSI-specific modules into evidence-based school prevention programs is feasible and does not lead to iatrogenic effects. Future work is needed to evaluate the potential (longer-term) benefits of incorporating NSSI-focused modules to evidence-based mental health programs in the prevention of NSSI.

The Face of Mental Health: Kevin Love and Hegemonic Masculinity in the NBA

While public discussion about mental illness has become increasingly common in the United States, previous research has found that having a mental illness diagnosis is assumed to be incompatible with elite athletic success. As explored in hegemonic masculinity scholarship, to be successful, professional male athletes attempt to physically dominate opponents. In 2018, National Basketball Association (NBA) star Kevin Love disclosed having a panic attack during a game as well as living with depression and anxiety. While Love was not the only NBA player to publicly come forward to discuss their mental health experiences, Love is a successful White player in a league where 73.9% of players self-identify as Black or African American. His social location connects his public health discussion to existing scholarship on whiteness, hegemonic masculinity, and mental illness. Love was praised for his willingness to speak about his personal experiences and provide support for others. However, through a critical discourse analysis of sports media coverage of Love’s disclosure and subsequent mental health advocacy, this study reveals that his public discussion was constructed in terms of his identity as a White athlete and constrained by expectations of hegemonic masculinity.

Profiles of narcissism and self-esteem associated with comprehensive mental health in adolescents

IntroductionThis study firstly aimed to identify different profiles of narcissism and self-esteem in adolescents using latent profile analysis (LPA). A secondary aim was to examine associations between the identified profiles and subsequent measures of comprehensive mental health. MethodsChinese adolescents (N = 1009, 50.8%girls, Mage = 12.99, SD = 0.66) completed a packet of measures on two occasions at 6-month intervals. Narcissism and self-esteem were assessed at Time 1. Positive and negative indicators of mental health were assessed at Time 2. ResultsLatent profile analysis of narcissism and self-esteem identified six profiles: (1) high narcissism and high self-esteem; (2) high-moderate self-regard; (3) moderate self-regard; (4) low-moderate self-regard; (5) high narcissism but low self-esteem; (6) low self-regard. Adolescents in the high narcissism and high self-esteem and high-moderate self-regard profiles displayed positive mental health outcomes whereas adolescents in the high narcissism but low self-esteem and low self-regard profiles reported problematic mental health outcomes. ConclusionDiffering profiles of narcissism and self-esteem in adolescents were identified; these profiles provide new insight into the structure of self-concept for adolescents. Further, the identified profiles of narcissism and self-esteem were differentially related to subsequent comprehensive mental health outcomes.

Parental Exposure to Childhood Maltreatment and Offspring's Mental Health: Investigating Pathways Through Parental Adversity and Offspring Exposure to Maltreatment.

Parental exposure to child maltreatment (CM) is an important predictor of their offspring's CM experiences and mental health. However, less attention has been paid to examine possible mechanisms of transmission, which is critical to inform prevention and intervention efforts. The current study tested (1) whether the association between parental CM exposure and offspring CM exposure was mediated by (a) parental exposure to violence in adulthood or (b) other emotional stressors/adversities in adulthood and (2) the indirect effects from parental CM exposure to offspring mental health outcomes through parental adversity and offspring CM exposure. Data came from a longitudinal study of maltreatment on adolescent development, and analyses focused on adolescents living with a biological parent (N = 185, 51% female). Biological parents (95% mothers) reported on their history of CM and exposure to other adversities across their lifetime. Adolescents self-reported lifetime CM experiences and current depression, anxiety, posttraumatic stress disorder, and externalizing behaviors in late adolescence (Mage = 18.49). Results showed a significant indirect effect of parent CM exposure on offspring's CM exposure and mental health through parental emotional stressors/adversities, but not physical violence. These findings highlight different types of stressors that may impact the risk for intergenerational transmission of CM and subsequent offspring mental health.

Does childhood mental health service use predict subsequent mental health service use during Latino youth transition to young adulthood? Evidence from the Boricua Youth Study.

Studies document the substantial underutilization of mental health services by US Latinos in young adulthood. Rates of service use are higher in childhood, raising questions about whether mental health service use during childhood may facilitate access to services later in life. This article examines the extent to which utilization of mental health services in childhood is predictive of utilization in young adulthood among US Latinos. Data come from the Boricua Youth Study, a longitudinal study of Puerto Rican youth at two sites (South Bronx, New York, and the standard metropolitan area of San Juan, Puerto Rico). Data were collected in three waves during childhood (ages 5-13; surveyed 1year apart), with an approximately 11-year follow-up in young adulthood (ages 16-29). In childhood, parents reported on youth mental health service use (Waves 1-3). In Wave 4, as youth transitioned to young adults (N = 2004), they reported on their past year mental health service use. Whereas 30.2% of parents reported their child received mental health services, only 3.5% of young adults reported mental health service use in the past year. After controlling for young adult disorders and their severity, childhood disorders were associated with increased likelihood of mental health service use in young adulthood. Childhood mental health service use was also associated with young adult service use; however, this association attenuated when controlling for childhood disorders. Findings suggest the importance of specifically considering childhood disorders in understanding mechanisms for improving access to mental health services among Latino young adults.

“Best-Laid Plans”: Barriers to Meeting Marital Timing Desires Over the Life Course

Most youth desire to marry, and often around a certain age, but many individuals marry earlier or later than originally desired. Off-time marriage could have consequences for subsequent relationship stability and mental health. Whereas barriers to marriage goals in the short term have been studied extensively, predictors of meeting marital timing expectations over the life course are less well understood. This study examined possible barriers, including socioeconomic characteristics and family experiences, both background and formation, to meeting marital timing desires by age 40 using data from the National Longitudinal Survey of Youth 1979 cohort (NLSY79). Multinomial logistic regression revealed that greater education, religiousness, cohabitation, and premarital childbearing were associated with delayed or forgone marriage, but associations varied by gender and the age at which respondents stated their expectations.

Turning Back to Treatment: The Effect of Attendance and Symptom Outcomes on Subsequent Service Use.

This study explored whether post-treatment symptom severity moderated the association between session attendance during an initial treatment episode and subsequent mental health service use. Data on attendance, symptom severity, and service use were gathered from an effectiveness trial testing a modular treatment for youth anxiety, depression, disruptive behavior, and traumatic stress. Multilevel logistic regression analyses showed a significant interaction between attendance and post-treatment symptom severity on subsequent service use, such that attendance significantly predicted subsequent service use when post-treatment symptom severity was in the normal range. Implications regarding the influence of treatment engagement on future help-seeking are discussed.

"If somebody could just understand what I am going through, it would make all the difference": Conceptualizations of trauma in homeless populations experiencing severe mental illness.

Exposure to violence, vulnerability due to lack of shelter, alienation due to stigma, the experiences of severe mental illness (SMI) and subsequent institutionalization, make homeless persons with SMI uniquely susceptible to trauma exposure and subsequent mental health consequences. This study aims to contribute to the development of culturally sensitive interventions for identifying and treating trauma in a population of homeless persons with SMI in Tamil Nadu, India by understanding the manifestations of trauma and its associated consequences in this population. Free-listing exercises followed by in-depth interviews were conducted with a convenience sample of 26 user-survivors who have experienced homelessness or were at risk of homelessness, and suffered from SMI. Topics explored included events considered to be traumatic, pathways to trauma, associated emotional, physical and social complaints, and coping strategies. Results indicate discrepancies in classification of traumatic events between user-survivors and the Diagnostic and Statistical Manual of Mental Disorders. Traumatic experiences, particularly relating to social relationships and poverty, mentioned by user-survivors did not match traditional conceptualizations of trauma. Positive coping strategies for trauma included being mentally strong, knowledge and awareness, whereas the main negative coping strategy is avoidance. User-survivors attributed their experiences of homelessness and SMI to past traumas. Differing views of trauma between user-survivors and mental health professionals can lead to misdiagnosis and under-recognition of trauma in this population of homeless persons with SMI.

Active and Passive Social Networking Sites Usage and Negative Emotions: A Reciprocal Relationship?

Introduction: The increasing popularity of social networking sites (SNS) has stimulated research on the relationship between SNS usage and users' mental health. The current study aims to shed light on the possible reciprocal relationship between type of SNS usage and subsequent mental health among Chinese college students. Method: A latent variable cross-lagged panel analysis (two waves) was conducted (N = 266). Results showed that negative emotions (loneliness, depression) at Time 1 (T1) was positively related to both active SNS usage and passive SNS usage at Time 2 (T2). However, neither active nor passive SNS usage at T1 was found to be associated with negative emotions at T2. Discussion: In this current research, the key finding is that type of usage did not impact on users' mental health. Future research might investigate the role of individual and social factors (e.g., self-esteem and life satisfaction) in moderating the relationship between SNS use and mental health.

How strong is my safety net? Perceived unemployment insurance generosity and implications for job search, mental health, and reemployment.

While social science has substantially documented the individual experience of unemployment, less is known about the role of contextual variables. One contextual factor that is important for unemployed job seekers is the unemployment insurance (UI) that they receive. This study examines the relationships between job seeker perceptions of UI generosity and mental health during unemployment, reemployment speed, and reemployment quality. Drawing upon psychological construal theory, we conceptualize UI generosity as creating psychological distance from the reemployment goal, generating consequences for the job search, mental health, and reemployment. We tested our hypotheses with a four-wave survey design of job seekers looking for work in 3 different countries (United States, Germany, and the Netherlands). Perceived UI generosity was associated with slower reemployment speed, via reduced time pressure, job search priority, and job search metacognition. Perceived UI generosity was related to higher mental health, via reduced time pressure and financial strain. Finally, perceived UI generosity was related to increased reemployment quality, both directly as well as indirectly through lower time pressure and financial strain, and subsequent higher mental health. Our findings provide previously unavailable empirical insight into the mechanisms explaining the positive and negative outcomes of UI generosity. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Care pathways, engagement and outcomes associated with a recovery-oriented intermediate stay mental health program

This study examined care pathways, program engagement, and key outcomes associated with a sub-acute inpatient stay in a 20-bed stand-alone Intermediate Stay Mental Health Unit (ISMHU; NSW, Australia). A 6-week evidenced-based tailored intervention program was offered, utilizing a recovery-oriented model of care. Service data from multiple record systems were combined, including admissions and service contacts 2-years prior to and following the index admission. During the initial 16-months there were 146 index admissions with a length of stay greater than 7 days. The majority (75.3%) were transfers from acute-care, with an average ISMHU stay of 50.3 days. Service and clinical outcomes were examined in relation to care pathways, recovery needs, program engagement and benefits achieved. Substantial engagement was detected (e.g., 74.0% >10 intervention types), together with significant improvements on self-report and clinician rated measures (e.g., social connection, symptoms, and self-belief). Logistic regression analyses revealed that arrival category was the strongest outcome predictor, with community referrals experiencing the largest reduction in subsequent acute mental health admissions (58.3% to 16.7%), followed by involuntary inpatient referrals (80.3% to 60.7%). Potential recovery-focused benefits are not limited to community treatment settings, while pathways to care may help identify clients with differing needs and opportunities for treatment.

Effect of Daily Teacher Feedback on Subsequent Motivation and Mental Health Outcomes in Fifth Grade Students: a Person-Centered Analysis.

Prevention scientists recognize that implementing effective prevention practices and programs responsive to the needs of individuals but based solely upon the findings from variable-centered methods presents several limitations due to numerous risk factors, pathways, and unobserved influences. One such understudied influence that is masked by variable-centered methods, motivation, is a person-level characteristic that influences treatment outcomes. The purpose of this paper is to demonstrate the use of an alternative person-centered approach, group iterative multiple model estimation (GIMME), to model change over time that focuses on the interdependence of daily student motivation levels and teacher feedback and their relations to student outcomes over time. Specifically, we used GIMME to model person level responses to negative teacher feedback regarding students' next day motivational ratings using data from 58 5th grade students participating in a study of the impact of the self-monitoring and regulation training strategy (SMARTS). Results identified a set of SMARTS students whose daily readiness aligned with high rates of self and teacher agreement regarding ongoing performance ratings. However, results identified a group of students whose daily motivation and readiness for change was adversely impacted by negative teacher feedback the day before. For these students, they were more likely than their peers to experience high levels of depression and internalization scores. Motivationally oriented practice suggestions for providing feedback to students who may be sensitive to this type of feedback and research implications of these findings are discussed.

School-based interventions for preventing substance use in indigenous children ages 7–13: a scoping review protocol

IntroductionThroughout the world, indigenous peoples share traumatic colonial experiences that have caused gross inequalities for them and continue to impact every aspect of their lives. The effect of intergenerational trauma...

Mental health in the aftermath of COVID-19: A new normal.

The COVID-19 pandemic with its subsequent mental health consequences has challenged the word view of most people. A genome typically of 26,000-32,000 bases long RNA has shut down the wheel of man made progress. The social isolation after the lock-down has not only led to economic difficulties but also adverse psychological reactions. The most common reaction is stress, anxiety and depression when faced with life-threatening circumstances. People have to deal with the imminent issue of death which is anxiety provoking in itself. This calls for dealing with the immediate mental health consequences with the aide of technological advancements as discussed in this write-up. A new inter-personal ethics need to emerge which is scientifically correct and in-line with age old values.