Symptoms Of Mental Health Disorders Research Articles

Mindfulness in Pediatrics: Practices to Improve Clinician and Patient Mental Health and Enhance Well-Being.

Children and adolescents with symptoms of mental health disorders often present to primary care settings. In the context of the coronavirus disease 2019 pandemic, mental health symptoms in children, adolescents, families, and health care clinicians are rising. Mindfulness is an approach to improve both mental and physical health that can be practiced freely in any circumstance. Although not a panacea, research does support the use of mindfulness-based practices not only to improve overall well-being but also to address a variety of symptoms and diagnoses in numerous populations. This review defines mindfulness, describes the current state of the literature, outlines ways to support youth and families in cultivating and applying mindfulness in their daily lives, and provides guidance for health care clinicians on how to begin a personal practice to support their own health and well-being. [Pediatr Ann. 2021;50(2):e77-e83.].

A 12-month prospective cohort study on symptoms of mental health disorders among Dutch former elite athletes

ABSTRACT Objectives The primary objectives of the study were to (i) establish the 12-month incidence and comorbidity of symptoms of mental health disorders (distress, anxiety/depression, sleep disturbance, alcohol misuse, disordered eating) among Dutch former elite athletes and (ii) explore the potential relationship with the stressors involuntary retirement, recent life events, career dissatisfaction. The secondary objective was to investigate whether the incidence of symptoms of mental health disorders and their potential relationship with stressors are related to duration since retirement. Methods An observational prospective cohort study with a 12-month follow-up was conducted among Dutch former elite athletes. Symptoms of mental health disorders and potential stressors were assessed using validated questionnaires. Results A total of 282 participants were included at baseline and 193 completed follow-up. The incidence ranged from 7% for alcohol misuse to 28% for anxiety/depression. Comorbidity of two or three symptoms of mental health disorders was reported in 7% and 4%, respectively. Adverse life events were significantly related to disordered eating (RR = 1.30, 95%CI = 1.05–1.61), while career dissatisfaction also showed a significant relationship with disordered eating (RR = 3.98, 95%CI = 1.32–11.99) and sleep disturbance (RR = 3.23, 95%CI = 1.10–9.51). The stressor involuntary retirement did not have a significant relationship with any symptoms of mental health disorders. The effect of duration since retirement seemed to be most present in the first 15 years since athletic career retirement in the plotted graphs. Conclusions The 12-month incidence of symptoms of mental health disorders ranged from 7% to 28% and comorbidity of symptoms of mental health disorders was present in 12%. Adverse life events and career dissatisfaction only increased the risk of certain symptoms of mental health disorders. Duration since retirement might affect the incidence of symptoms of mental health disorders and its relationship with stressors in the first 15 years.

Smartphone-Based Interventions and Internalizing Disorders in Youth: Systematic Review and Meta-analysis

BackgroundMental health disorders in youth are a global issue that have important implications for the future quality of life and morbidity of affected individuals. In the context of public health initiatives, smartphone-based interventions have been suggested to hold the potential to be an effective strategy to reduce the symptoms of mental health disorders in youth; however, further evaluation is needed to confirm their effectiveness. This systematic review and meta-analysis documents and synthesizes existing research on smartphone-based interventions targeting internalizing disorders in youth populations.ObjectiveThis study aims to synthesize existing research on smartphone-based interventions targeting internalizing disorders in youth populations.MethodsPubMed and SCOPUS were searched in 2019, and 4334 potentially relevant articles were found. A total of 12 studies were included in the final synthesis. We used the Hedges g meta-analysis approach and a random effects model for analysis.ResultsThe results of this review note that depression and anxiety are the most commonly targeted symptoms, and unlike other similar topics, most studies reviewed were linked to a proven treatment. The overall pooled effect from the meta-analysis showed small but significant effects (κ=12; N=1370; Hedges g=0.20; 95% CI 0.02-0.38) for interventions in reducing the symptoms of internalizing disorders. In total, 4 subgroup analyses examining specific symptoms and intervention styles found varied small significant and nonsignificant effects.ConclusionsFuture research should focus on developing robust evaluative frameworks and examining interventions among more diverse populations and settings. More robust research is needed before smartphone-based interventions are scaled up and used at the population level to address youth internalizing disorders.

Prevalence and Factors Associated With Mental Health Symptoms in Adults Undergoing Covid-19 Testing.

Background and objective:Understanding the mental health impact of the COVID-19 pandemic on persons receiving COVID-19 testing will help guide mental health interventions. We aimed to determine the association between sociodemographic factors and mental health symptoms at 8 weeks (baseline) after a COVID-19 test, and compare prevalence of mental health symptoms at baseline to those at 16-week follow-up.Materials and Methods:Prospective cohort study of adults who received outpatient COVID-19 testing at primary care clinics. Logistic regression analyses were used to assess the association between sociodemographic characteristics and COVID-19 test results with mental health symptoms. Mental health symptoms reported at baseline were compared to symptoms at 16 weeks follow-up using conditional logistic regression analyses.Results:At baseline, a total of 124 (47.51%) participants reported at least mild depressive symptoms, 110 (42.15%) participants endorsed at least mild anxiety symptoms, and 94 participants (35.21%) endorsed hazardous use of alcohol. Females compared to males were at increased risk of at least mild depressive symptoms at baseline (Adjusted Odds Ratio (AOR): 2.08; 95% CI: 1.14-3.79). The odds of at least mild depressive symptoms was significantly lower among those residing in zip codes within the highest quartile compared to lowest quartile of household income (AOR: 0.37; 95% CI: 0.17-0.81). Also, non-Hispanic Whites had significantly higher odds of reporting hazardous alcohol use compared to non-Whites at baseline (AOR: 1.94; 95% CI: 1.05-3.57). The prevalence of mental health symptoms remained elevated after 16 weeks.Conclusion and Relevance:We found a high burden of symptoms of depression and anxiety as well as hazardous alcohol use in a diverse population who received testing for COVID-19 in the primary care setting. Primary care providers need to remain vigilant in screening for symptoms of mental health disorders in patients tested for COVID-19 well after initial testing.

Examining differences in suicidality between and within mental health disorders and sexual identity among adults in the United States.

BackgroundSuicide is a leading but preventable cause of death and is preceded by domains of thoughts, plans, and attempts. We assessed the prevalence of suicidality domains and determined the association of suicidality domains with sexual identity, mental health disorder symptoms, and sociodemographic characteristics.MethodsWe used the 2019 National Survey on Drug Use and Health (NSDUH) data to perform weighted multivariable logistic regression and margins analyses to examine between and within-group differences in suicidality by sexual identity among adults aged ≥ 18 years.ResultsAbout 4.89%, 1.37%, and 0.56% of the population experienced suicidal thoughts, plans, and attempts, respectively. Those aged 18–25 years old had a higher odds of suicidality compared to those aged 26 years or older. Compared to those who reported having no alcohol use dependence, illicit drug use dependence, and major depressive episodes (MDEs), those who reported alcohol use dependence, illicit drug use dependence, and MDE had higher odds of suicidal thoughts, plans, and attempts. Between all sexual identity groups, bisexuals who experienced MDEs had the highest probability of having suicidal thoughts while lesbians and gays who experienced MDE showed a higher probability of suicidal plans and attempts compared to heterosexuals. Within each sexual identity group, the probability of having suicidal thoughts, suicidal plans, and suicidal attempts was higher for those who had experienced MDEs compared to those who had not experienced MDEs.ConclusionSubstance use disorder and MDE symptoms were associated with increased suicidality, especially among young adults and sexual minority people. This disparity underscores the need for tailored interventions and policies to enhance the provision of prompt mental health screening, diagnosis, and linkage to care for mental health services, particularly among the most vulnerable in the population.

Can athletes be tough yet compassionate to themselves? Practical implications for NCAA mental health best practice no. 4.

Recent tragic events and data from official NCAA reports suggest student-athletes' well-being is compromised by symptoms of mental health (MH) disorders. Self-compassion (SC) and mental toughness (MT) are two psychological constructs that have been shown effective against stressors associated with sports. The purpose of this study was to investigate SC, MT, and MH in a NCAA environment for the first time and provide practical suggestions for MH best practice No.4. In total, 542 student-athletes participated across Divisions (Mage = 19.84, SD = 1.7). Data were collected through Mental Toughness Index, Self-Compassion Scale, and Mental Health Continuum-Short Form. MT, SC (including mindfulness), and MH were positively correlated. Males scored higher than females on all three scales. No differences were found between divisions. SC partially mediated the MT-MH relationship, but moderation was not significant. Working towards NCAA MH best practice should include training athletes in both MT and SC skills (via mindfulness).

Predictors and correlates of lifetime and persistent non-suicidal self-injury and suicide attempts among adult survivors of childhood sexual abuse

ABSTRACT Background: Childhood sexual abuse (CSA) is a well-established risk factor for non-suicidal self-injury (NSSI) and suicide attempts (SA); still few studies have examined predictors of individual differences in NSSI/SA amongst CSA survivors. Objective: To examine predictors of NSSI and SA among adult CSA-survivors. Methods: In a sample of 516, primarily female adult CSA-survivors recruited from support centres for sexual abuse survivors in Norway, we examined the role of abuse/perpetrator characteristics, and the degree/severity of exposure to other types of childhood maltreatment (cumulative childhood maltreatment; CCM), as predictors of lifetime NSSI and SA. In a subsample of 138 individuals responding to follow-up waves two- and four years later, these same distal factors, as well as previous NSSI and proximal factors in the form of symptoms of mental health disorders (posttraumatic stress, anxiety, depression, sleep disturbances, and eating disorders), relational problems, and perceived social support, were examined as predictors of persistent NSSI. Finally, those attempting new SA during the follow-up period were compared to those who did not on these variables. Results: Higher CCM scores and having had an unknown perpetrator positively predicted lifetime NSSI scores. Higher CCM scores, violent abuse, and having had an unknown perpetrator predicted lifetime SA. Higher CCM scores, previous NSSI, having had a known perpetrator, as well as higher depression-, anxiety- and eating disorder scores, positively predicted persistent NSSI during the four-year follow-up period. Compared to those with no new SA, those reporting new SA during the follow-up period had higher CCM, lifetime NSSI, mental health symptoms and relational problem scores, lower perceived social support scores, and were more likely to have done a past SA and to have experienced abuse involving physical violence. Conclusions: A broad range of both distal and proximal factors should be assessed as potential predictors of NSSI and SA among adult CSA-survivors.

Symptoms of Anxiety, Depression, and Peritraumatic Dissociation in Critical Care Clinicians Managing Patients with COVID-19. A Cross-Sectional Study.

Rationale: Frontline healthcare providers (HCPs) during the coronavirus disease (COVID-19) pandemic are at high risk of mental morbidity.Objectives: To assess the prevalence of symptoms of anxiety, depression, and peritraumatic dissociation in HCPs.Methods: This was a cross-sectional study in 21 ICUs in France between April 20, 2020, and May 21, 2020. The Hospital Anxiety and Depression Scale and the Peritraumatic Dissociative Experience Questionnaire were used. Factors independently associated with reported symptoms of mental health disorders were identified.Measurements and Main Results: The response rate was 67%, with 1,058 respondents (median age 33 yr; 71% women; 68% nursing staff). The prevalence of symptoms of anxiety, depression, and peritraumatic dissociation was 50.4%, 30.4%, and 32%, respectively, with the highest rates in nurses. By multivariable analysis, male sex was independently associated with lower prevalence of symptoms of anxiety, depression, and peritraumatic dissociation (odds ratio of 0.58 [95% confidence interval, 0.42–0.79], 0.57 [95% confidence interval, 0.39–0.82], and 0.49 [95% confidence interval, 0.34–0.72], respectively). HCPs working in non–university-affiliated hospitals and nursing assistants were at high risk of symptoms of anxiety and peritraumatic dissociation. Importantly, we identified the following six modifiable determinants of symptoms of mental health disorders: fear of being infected, inability to rest, inability to care for family, struggling with difficult emotions, regret about the restrictions in visitation policies, and witnessing hasty end-of-life decisions.Conclusions: HCPs experience high levels of psychological burden during the COVID-19 pandemic. Hospitals, ICU directors, and ICU staff must devise strategies to overcome the modifiable determinants of adverse mental illness symptoms.

How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years

BackgroundApproximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. MethodsUsing self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. ResultsConsistent associations between fathers’ subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. LimitationsThis study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. ConclusionsA low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.

Problems faced by Syrian refugees and asylum seekers in Switzerland

BACKGROUND Refugees and asylum seekers are susceptible to developing common mental disorders due to their exposure to stressful experiences before, during and after their flight. The Syrian Civil War, which started in 2011, has led to a massive number of Syrians seeking refuge and asylum in European countries, including Switzerland. Currently, Syrians are the second-largest refugee and asylum-seeking population in Switzerland. However, very little is known about the problems faced by this new population in Switzerland and their needs relating to mental health services. Identifying the problems faced by this community is crucial to providing adapted and tailored mental health services to Syrian refugees in Switzerland. AIM OF THE STUDY The current study aimed to identify problems that Syrian refugees and asylum seekers face daily while living in Switzerland in order to inform the adaptation of a brief psychological intervention. METHODS We used a cross-sectional, qualitative design and collected data according to The Manual for Design, Implementation, Monitoring and Evaluation of Mental Health and Psychosocial Assistance Programs for Trauma Survivors in order to identify problems perceived by the target population. Free-listing, open-ended interviews were conducted with 30 adult Syrian refugees and asylum seekers and analyzed using thematic analysis. RESULTS The results show that besides physical health problems, Syrians experience primarily two types of problems: practical and psychological (emotional) problems. These two types of problems are closely interrelated. The most common practical problems (problems with government and authorities, problems related to residence permits, problems with integration, cultural differences, language problems, problems related to education, problems related to employment, and problems with housing) were reported by almost half of all participants. Symptoms of mental disorders and feelings of uncertainty, frustration and injustice were the most common psychological problems and were mentioned by more than one third of the participants. The finding that almost half of the participants reported typical symptoms of mental health disorders suggests that a considerable number of Syrian refugees and asylum seekers might need mental healthcare. CONCLUSIONS Authorities, practitioners and researchers should recognize that Syrian refugees and asylum seekers are strongly affected by a broad range of problems. Besides practical problems, they suffer a multitude of psychological problems, and a significant number of them report, among other issues, symptoms of mental health disorders. Officials working with this population should be aware of this vulnerability and be prepared to refer clients in need of mental healthcare to mental healthcare providers. Moreover, the significant variety and number of problems experienced by this population should be taken into consideration when developing solutions tailored to their needs.

Preventing maternal mental health disorders in the context of poverty: pilot efficacy of a dyadic intervention

The United States Preventive Services Task Force recommends that clinicians provide or refer pregnant and postpartum women who are at an increased risk of perinatal depression to counseling interventions. However, this prevention goal requires effective interventions that reach women at risk of, but before, the development of a depressive disorder. We describe a pilot efficacy trial of a novel dyadic intervention to prevent common maternal mental health disorders, that is, Practical Resources for Effective Postpartum Parenting, in a sample of women at risk of maternal mental health disorders based on poverty status. We hypothesized that Practical Resources for Effective Postpartum Parenting compared with enhanced treatment as usual would reduce symptoms of maternal mental health disorders after birth. A total of 60 pregnant women who were recruited from obstetrical practices at Columbia University Irving Medical Center were randomized to the Practical Resources for Effective Postpartum Parenting (n=30) or enhanced treatment as usual (n=30) intervention. The Edinburgh Postnatal Depression Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Patient Health Questionnaire were used to compare maternal mood at 6 weeks, 10 weeks, and 16 weeks after delivery. At 6 weeks after delivery, women randomized to Practical Resources for Effective Postpartum Parenting had lower mean Edinburgh Postnatal Depression scores (P=.018), lower mean Hamilton Depression scores (P<.001), and lower mean Hamilton Anxiety scores (P=.041); however, the incidence of postpartum mental disorders did not differ by treatment group. The Practical Resources for Effective Postpartum Parenting, which is an intervention integrated within obstetrical care, improves subclinical symptomology for at-risk dyads at a crucial time in the early postpartum period; however, our study did not detect reductions in the incidence of postpartum mental disorders.

The effects of polygenic risk for psychiatric disorders and smoking behaviour on psychotic experiences in UK Biobank

While psychotic experiences are core symptoms of mental health disorders like schizophrenia, they are also reported by 5–10% of the population. Both smoking behaviour and genetic risk for psychiatric disorders have been associated with psychotic experiences, but the interplay between these factors remains poorly understood. We tested whether smoking status, maternal smoking around birth, and number of packs smoked/year were associated with lifetime occurrence of three psychotic experiences phenotypes: delusions (n = 2067), hallucinations (n = 6689), and any psychotic experience (delusions or hallucinations; n = 7803) in 157,366 UK Biobank participants. We next calculated polygenic risk scores for schizophrenia (PRSSCZ), bipolar disorder (PRSBP), major depression (PRSDEP) and attention deficit hyperactivity disorder (PRSADHD) in 144,818 UK Biobank participants of European ancestry to assess whether association between smoking and psychotic experiences was attenuated after adjustment of diagnosis of psychiatric disorders and the PRSs. Finally, we investigated whether smoking exacerbates the effects of genetic predisposition on the psychotic phenotypes in gene-environment interaction models. Smoking status, maternal smoking, and number of packs smoked/year were associated with psychotic experiences (p < 1.77 × 10−5). Except for packs smoked/year, effects were attenuated but remained significant after adjustment for diagnosis of psychiatric disorders and PRSs (p < 1.99 × 10−3). Gene-environment interaction models showed the effects of PRSDEP and PRSADHD (but not PRSSCZ or PRSBP) on delusions (but not hallucinations) were significantly greater in current smokers compared to never smokers (p < 0.002). There were no significant gene-environment interactions for maternal smoking nor for number of packs smoked/year. Our results suggest that both genetic risk of psychiatric disorders and smoking status may have independent and synergistic effects on specific types of psychotic experiences.

Current state of scientific evidence on Internet-based interventions for the treatment of depression, anxiety, eating disorders and substance abuse: an overview of systematic reviews and meta-analyses.

BackgroundICare represents a consortium of European Investigators examining the effects of online mental health care for a variety of common mental health disorders provided in a variety of settings. This article provides an overview of the evidence of effectiveness for Internet-based treatment for four common mental health disorders that are the focus of much of this work: depression, anxiety, substance abuse and eating disorders.MethodsThe overview focused primarily on systematic reviews and meta-analyses identified through PubMed (Ovid) and other databases and published in English. Given the large number of reviews specific to depression, anxiety, substance abuse and/or eating disorders, we did not focus on reviews that examined the effects of Internet-based interventions on mental health disorders in general. Each article was reviewed and summarized by one of the senior authors, and this review was then reviewed by the other senior authors. We did not address issues of prevention, cost-effectiveness, implementation or dissemination, as these are addressed in other reviews in this supplement.ResultsAcross Internet-based intervention studies addressing depression, anxiety, substance abuse and eating disorders primarily among adults, almost all reviews and meta-analyses found that these interventions successfully reduce symptoms and are efficacious treatments. Generally, effect sizes for Internet-based interventions treating eating disorders and substance abuse are lower compared with interventions for depression and anxiety.ConclusionsGiven the effectiveness of Internet-based interventions to reduce symptoms of these common mental health disorders, efforts are needed to examine issues of how they can be best disseminated and implemented in a variety of health care and other settings.

Online therapeutic methods: A systematic review

The purpose of this systematic review was to evaluate which available online therapeutic methods, could be utilized as an alternative to conventional face-to-face therapy for individuals suffering from various mental health disorders. Database searches were conducted using topic-related search terms and predetermined inclusion criteria. The final collection of articles used for this systematic review was comprised of 8 articles. Randomized control trials were used for 7 of the studies, while the only exception was a randomized parallel group trial. This systematic review evaluated the influence of the interventions on the respective study participants. Each study reported notable results, which indicated that dispensing online Cognitive Behavioral Therapy was a viable means of reducing the symptoms of certain mental health disorders. The involvement of a therapist also demonstrated better results than self-help programs, even if only slightly, and usually the positive effects of treatment lasted longer when a therapist-client relationship was present. This was evidenced in post-treatment follow-ups. Online therapy displayed promise in the treatment of certain mental health disorders. A therapeutic alliance was shown to be an important aspect in determining treatment outcomes and more research is required into the application of online therapeutic methods in developing contexts.

The impact of having inadequate safety equipment on mental health.

BackgroundConcerns are being raised about the impact of inadequate safety equipment on the mental health of healthcare workers during the COVID-19 medical response.AimsTo assess the impact of inadequate safety equipment on the mental health of service personnel deployed on operations in order to better understand the impact on those working under the similarly demanding conditions of the COVID-19 medical response.MethodsSelf-report surveys were conducted in four operational environments with 3435 personnel providing data. Surveys recorded data on socio-demographic, military and operational characteristics, mental health measures and specific occupational stressors. Analysis through logistic regression explored the association between inadequate equipment and all other factors.ResultsA total of 3401 personnel provided data on their perceptions of the adequacy of their equipment, of which 532 (15%) stated that they had a lot of concerns that they did not have the right equipment in working order. Analysis found significantly greater odds of reporting symptoms of common mental health disorders (CMD), 2.49 (2.03–3.06), post-traumatic stress disorder (PTSD), 2.99 (2.11–4.24), poorer global health 2.09 (1.62–2.70) and emotional problems 1.69 (1.38–2.06) when individuals reported working with inadequate equipment. Analyses remained significant when adjusted for confounding factors such as rank, sex and operational environment.ConclusionsAn individual’s perception of having inadequate equipment is significantly associated with symptoms of CMD, probable PTSD, poorer global health and increased reporting of emotional problems. This in turn may impact on their ability to safely carry out their duties and may have longer-term mental health consequences.

Understanding mental health and its determinants from the perspective of adolescents: A qualitative study across diverse social settings in Indonesia.

Poor mental health is a leading contributor to the burden of disease experienced by adolescents, including in resource constrained settings. However, little is known about how adolescents in these countries conceptualise mental health and its determinants which is essential to informing effective responses. This study aimed to explore how adolescents in Indonesia (a populous and rapidly developing country) conceptualise mental health and what they identify as important determinants. Eight focus group discussions (FGDs) were conducted with 86 Indonesian adolescents (aged 16-18 years), sampled from schools and community settings from Jakarta and South Sulawesi. FGDs were recorded, transcribed, translated and thematically analysed. Mental health was recognised as a significant concern by adolescents in Indonesia. Good mental health was conceptualised as emotional wellbeing and happiness. By contrast, poor mental health was predominantly described in terms of substantial mental illness manifesting as behavioural and physical disturbance. Further, poor mental health only happened to 'other' people, with stigmatising views prevalent. Absent from the discussions were common symptoms of poor mental health (stress, loneliness, poor sleep) and common mental disorders (e.g. depression, anxiety) or a conceptualisation that reflected poor mental health to be a normal human experience. Discussions around determinants of poor mental health suggested that family connections (particularly with parents), school pressures, and adverse exposures on social media were important drivers of poor mental health, with religion also surfacing as an important determinant. In highlighting mental health as an important issue for Indonesian adolescents, this study provides a foundation for targeted responses.

Social support and mental health status of internal migrants in Beijing

We investigated the mental health status of 320 internal migrants in Beijing according to gender, age, marital status, and monthly income, and examined the relationship between their mental health status and social support mechanisms. Participants completed the self-report Symptom Checklist-90-R and Social Support Rating Scale. Results showed that their mental health was significantly worse than the Chinese adult norm as assessed in 2017. Participants' social support varied according to age, marital status, and monthly income. Female participants younger than 30 years old with a monthly income lower than 3,000 yuan comprised the group with the most mental health disorder symptoms. They thus required greater personal attention to their health. The results suggested that social support can predict mental health among internal migrants. Directions for further research are discussed.

Using the PBIS Framework to Meet the Mental Health Needs of Youth in Juvenile Justice Facilities

Youth in juvenile justice facilities may experience symptoms of mental health disorders and trauma at a higher rate than their normative peers. As a result, juvenile justice facilities have become de facto mental health agencies, resulting in an increased need to provide interventions that can meet the various needs of their residents. Embedding mental health and trauma-informed care into tiered facility-wide positive behavioral interventions and supports (FW-PBIS) is an emerging practice to meet a multitude of youth mental health symptoms. In this article, we provide examples of how mental health and trauma-informed care can be interwoven into an FW-PBIS framework by using a data-based decision-making process to guide the implementation of tiered evidence-based interventions, and we offer implications for practice and research.

Assessing the Relative Impact of Diverse Stressors among Public Safety Personnel.

Public Safety Personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent leadership styles) and operational elements (e.g., shift work, public scrutiny). The current research quantified occupational stressors across PSP categories and assessed for relationships with PPTEs and mental health disorders (e.g., anxiety, depression). The participants were 4820 PSP (31.7% women) responding to established self-report measures for PPTEs, occupational stressors, and mental disorder symptoms. PPTEs and occupational stressors were associated with mental health disorder symptoms (ps < 0.001). PSP reported substantial difficulties with occupational stressors associated with mental health disorder symptoms, even after accounting for diverse PPTE exposures. PPTEs may be inevitable for PSP and are related to mental health; however, leadership style, organizational engagement, stigma, sleep, and social environment are modifiable variables that appear significantly related to mental health.

One-Year Postpartum Mental Health Outcomes of Mothers of Infants with Neonatal Abstinence Syndrome.

Women with substance use disorders have high incidences of psychiatric and mood disorders, which may affect their ability to cope with an infant with neonatal abstinence syndrome (NAS), particularly one with a protracted NICU course, exacerbating symptoms of mental health disorders. We examined the incidence of mental health diagnoses in the first 12 postpartum months in mothers of an NAS infant compared to mothers of an infant without NAS. In this retrospective, cohort study, data were extracted from MarketScan® database (2005-2013). NAS newborns were identified using ICD-9 codes. Each mother of an NAS newborn was matched to a mother of a newborn without NAS on age at delivery, birth year, gestational age, NICU stay and maternal mental health diagnoses in the 9months prior to delivery. Primary outcomes were claims for major depression, postpartum depression, anxiety, adjustment reaction, post-traumatic stress disorder, and suicidal ideation. 338 mother-infant pairs met all inclusion/exclusion criteria and were matched 1-to-1 with controls. 245 (73%) of the NAS infants had a NICU admission. Median length of stay for these infants was 10days compared to 3days for infants with no NICU admission (p < 0.001). Mothers of NAS infants were more likely to have claims for major depression (33% vs. 15%, p < 0.01), postpartum depression (7% vs. 3%, p = 0.04), and anxiety (27% vs. 13%, p < 0.01). Mothers of infants with NAS have a higher incidence of mental health diagnoses in the first 12months postpartum compared to mothers of infants without NAS.