Mental Health Trajectories Research Articles

Economic Strain and Recovery Trajectories in Mental Health: The Role of Financial Stability in Mental Health Outcomes

This study explores the intricate relationship between financial stability and recovery from mental health, and clarifies how economic security constitutes an essential feature that enhances mental health results. The study has used SPSS in quantitative analysis for regression analysis, ANOVA, cluster analysis, and structural equation modeling to explore the determinants of influential predictors and patterns in linking financial stability with mental health recovery. The regression outcome showed that financial stability substantially predicts recovery (? = 0.52, p < 0.01), and ANOVA indicated large differences in the scores of recoveries among the financial groups (F = 8.15, p < 0.05). Cluster analysis also indicated a difference such that the average score of recovery for high-stability participants was 8.5, while for low-stability participants it was 4.1. Thus, SEM shows both direct and indirect effects as it manifests that financial stability indeed reduces stress and encourages treatment adherence. The study concludes that economic security indeed plays a multifaceted role ranging from the access of mental healthcare through income support programs to resilience and overall well-being through the promotion of living a financial stability life. Recommendations should include income support programs, financial literacy programs, and integrated financial and mental health support services to form sustainable recovery. Further longitudinal researches, with larger and more diverse samples, should be conducted to study the long-run impact of financial stability on mental health trajectories and tailor policy interventions accordingly.

Mental health trajectories across COVID-19 and beyond: South African occupational health surveillance data (2019–2023)

There are inconsistent reports on the impact of the COVID-19 pandemic and its associated social restrictions on mental health, with initial suggestions of an increased prevalence of mental disorders in South Africa. However, the longitudinal trajectories of mental health responses across the COVID-19 pandemic are not clear. The primary aim of this study was to describe the trajectories of self-reported common mental disorders, as determined by repeat administration of clinical screening tools across five consecutive years (from 2019 to 2023). A secondary aim was to consider associations with demographic factors such as gender and age. Point prevalence estimates were obtained from a South African occupational mental health surveillance programme in a stable workplace population. Trajectories of common mental disorders across COVID-19 were determined using the Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 to identify Major Depressive Disorder and Generalised Anxiety Disorder, respectively. Prevalence estimates for depression and anxiety disorders initially remained stable before increasing towards mid-2021 and returning to pre-COVID-19 estimates by end-2022. Suicidal ideation decreased early into the pandemic but returned to pre-COVID-19 levels by 2021. The study suggests that on a practical level, readily available access to mental health care remains an important mechanism to protect mental health during and after major societal disruptor events. This can further be supported through regular monitoring and through providing high-intensity early intervention for at least 18 to 24 months following such events.

Corrigendum to “Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic”

Corrigendum to “Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic”

Resilience to major life events: Advancing trajectory modeling and resilience factor identification by controlling for background stressor exposure.

Resilience has been defined as the maintenance or quick recovery of mental health during and after stressor exposure. One popular operationalization of this concept is to model prototypical trajectories of mental health in response to an adverse event, where trajectories of undisturbed low or rapidly recovering symptoms both comply with the resilience definition. However, mental health responses are likely also influenced by other stressors occurring before or during the observation time window. These "background" stressors may affect a person's assignment to a trajectory class. When using these classes as dependent variables to identify resilience-predictive factors, this may lead to false estimates. A new method to build exposure-controlled trajectories based on time courses of stressor reactivity (SR), rather than pure mental health scores, is demonstrated on a data set of 707 initially healthy participants living in Germany (67.33% female; Mage = 29.20, SD = 8.27). SR scores express individual deviations from the sample's normative mental health reaction to observed real-life stressors during the observation time window, thus accounting for individual differences in exposure to background stressors. The resulting trajectory models are plausible. In analyses additionally controlling for background stressors occurring before the observation time window (past life events), low SR trajectories are predicted by the well-documented resilience factor sense of coherence, suggesting construct validity. Further, they are associated with lower odds of developing categorical mental health conditions, suggesting predictive validity. Our study provides the first proof of principle for a refined method to identify predictors of resilience to major stressor events. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Lifestyle-specific association between adversity dimensions with group-based mental health trajectories.

Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems. This longitudinal study (n=1112, 54.5% male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle. Three trajectories of mental health problems were identified: persistently low risk (24.9%), persistently medium-high risk (50.0%), and persistently high risk (25.1%). Multinomial logistic regression showed that high adversity (high-threat: β=2.01, P<0.001; high-deprivation: β=1.03, P<0.001; high-unpredictability: β=0.83, P=0.001; high-overall adversity: β=1.64, P<0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys. The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data. This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.

Mental Health during Medical Transition in a US and Canadian Sample of Early Socially Transitioned Transgender Youth

PurposeThis study aimed to shed light on the mental health of a unique group of medically transitioning transgender adolescents: those who had made a binary social transition during childhood and who, in general, had not experienced substantial gender-incongruent puberty. MethodsStudy participants were part of a broader longitudinal study comprising 3 groups: transgender youth, their cisgender siblings, and unrelated cisgender peers. Using multilevel models, we compared self-reported and parent-reported levels of anxiety and depressive symptoms among transgender youth at 3 stages: before youth had begun puberty blockers; after they had begun blockers; and after they had begun hormone therapy. We also compared age-based mental health trajectories in transgender and cisgender youth. ResultsIn this sample of transgender youth who sought and received gender-affirming medical care, participants experienced stable and relatively low levels of psychological distress across stages of medical transition and across time. There was one exception: transgender girls showed increased, followed by decreased, parent-reported depressive symptoms over time. In contrast, cisgender girls showed increases in internalizing symptomatology (with the exception of parent-reported anxiety) as they got older, and cisgender boys showed decreased self-reported anxiety and increased, followed by decreased, parent-reported depressive symptoms. By mid-adolescence, levels of anxiety and depressive symptoms among transgender girls and transgender boys generally fell between those of cisgender girls and cisgender boys. DiscussionResults demonstrate that transgender youth who are socially and medically supported in their gender identity can experience stable and positive mental health throughout the notoriously challenging developmental period of adolescence.

Prenatal exposure to phthalates and children’s mental health trajectories: Rhea Cohort, Greece

Abstract Background Accumulating evidence suggests that phthalate exposure affects neurodevelopment, including emotional and behavioral outcomes. Our aim was to investigate if prenatal phthalate exposure affects the developmental course of internalizing and externalizing symptoms from early childhood to adolescence. Methods Concentrations of seven phthalate metabolites were measured in first-trimester maternal spot urine samples, and DEHP, and high and low molecular weight phthalate concentrations were calculated (HMW and LMW, respectively). Mothers reported internalizing and externalizing symptoms via the Strengths and Difficulties Questionnaire at 4 years and the Child Behavior Checklist at 6, 11 and 15 years. Group-Based Trajectory Modeling was used to classify 546 participants of the Rhea Cohort (Crete, Greece) into 4 distinct groups (Stable low, Stable high, Low-Increasing, and High-Decreasing symptoms). We evaluated the association of prenatal phthalate exposure with the odds of an adverse (Stable high, Low-Increasing, and High-Decreasing) internalizing and externalizing symptom trajectory in 150 children using multivariable-adjusted logistic regression (reference group: stable low). Results Only for girls, exposure to DEHP and HMW phthalates was associated with higher odds of being grouped in an adverse internalizing symptoms trajectory (OR [95%CI]: 1.52 [1.03, 2.25] and 1.57 [1.03, 2.39], respectively). Regarding externalizing symptoms, interactions with gender emerged for DEHP (p = 0.024) and HMW (p = 0.028) phthalates, and increased odds of being grouped into an adverse trajectory were observed in girls, whereas boys showed the opposite trend, albeit none reached statistical significance. Conclusions The findings suggest programming effects of prenatal phthalate exposure on the developmental course of emotional symptoms in girls. Further research is needed to clarify the association between in utero phthalate exposure and behavioral symptoms. Key messages • Phthalate exposure is linked to adverse trajectories of emotional symptoms, emerging from preschool age and up to adolescence. • Phthalate effect on internalizing and externalizing symptoms varies by gender.

Mental health trajectories among Syrian refugees in Norway: A longitudinal cohort study

Abstract Background Refugees encounter various risk factors that can affect their mental health throughout the migration process. However, while most studies focus on mental health challenges at the time of resettlement, only a few explore these changes over an extended period. This study aims to explore changes in mental health among Syrian refugees in Norway and to identify influencing factors. Methods This is a prospective cohort study using data from CHART and Integration for Health studies, which followed Syrian refugees granted settlement in Norway. Data collection took place in Lebanon between 2017-2018 (baseline), and at one- and four-years post-arrival in Norway. Assessments for anxiety/depression and post-traumatic stress disorder (PTSD) were conducted using the Hopkins Symptom Checklist (HSCL-10) and the Harvard Trauma Questionnaire, respectively. Mixed-effects logistic regression analyzed temporal changes, with results presented as odds ratio (OR) with 95% confidence intervals (CI). The study also explored the effect modification of outcomes by the following baseline factors: age, gender, education. Results A total of 132 participants were included in all three data collection points. There was a decrease in the proportion of participants reporting anxiety/depression (from 30% to 28%, OR 0.1, 95% CI 0.1 - 0.2) four years post-settlement. The proportion of participants reporting PTSD symptoms decreased one year after settlement (from 4% to 3%, OR 0.3, 95% CI 0.1 - 0.7), but increased to 4% four years after arrival, showing no improvement from baseline (OR 0.8, 95% CI 0.4 - 2.0). No interactions were observed between changes over time and baseline variables. Conclusions After four years in Norway, Syrian refugees reported improvement in anxiety/depression, but PTSD symptoms worsened. This highlights the need for ongoing support that extends beyond the initial phases of resettlement. Key messages • Refugees face various risk factors that affect their mental health throughout the migration process. • Ongoing mental health support for refugees is essential, beyond the initial resettlement phase.

Exploring anxiety and depression trends: insights from the BELHEALTH cohort 2022-2024 in Belgium

Abstract Background The swift impact of the COVID-19 pandemic and ensuing restrictions on the mental health of the Belgian population prompted the need for a sustainable system to monitor its evolution. Repeated COVID-19 surveys were conducted between 2020 and 2022 to address this issue, followed by the launch of the BELHEALTH cohort project. Our study aims to analyze the trajectory of anxiety and depression at the post-pandemic period, using data from five waves of the BELHEALTH longitudinal surveys from October 2022 to March 2024. High-risk groups and the potential of social support and resilience to mitigate anxiety and depression were explored. Methods The BELHEALTH follow-up cohort of around 7,300 Belgian residents uses online surveys to assess anxiety (with the GAD-7), and depression (with the PHQ-9). The analyses were performed using linear mixed models on the 3,676 individuals who participated in all five waves. Results Preliminary results indicated that more people were affected by anxiety in October 2022 (16%) compared to June 2023 (14%), while depression rates were lower in October 2022 (13%) compared to February 2023 (14%) and March 2024 (15%). However, the trajectory of mental health varied across demographic subgroups, with worse outcomes observed among unemployed and younger individuals, as well as those living alone, in the Walloon Region (South of Belgium). Overall, people with a low level of resilience or a low level of social support exhibited higher odds of experiencing depression. Conclusions Reducing these social inequities in mental health necessitates the development of structural prevention measures and interventions at the regional level. These measures should target factors such as unemployment, which is particularly prevalent among younger individuals and those living in Wallonia. Additionally, fostering protective factors such as social support and resilience is crucial for mitigating mental health inequalities over time. Key messages • Monitoring mental health and its determinants remains crucial to identify and address social inequities, tailor interventions, and support vulnerable populations. • Unemployed, younger people, and those residing in the Walloon region are at particular risk.

Social inequalities in child mental health trajectories: a longitudinal study using birth cohort data 12 countries

BackgroundSocial inequalities in child mental health are an important public health concern. Whilst previous studies have examined inequalities at a single time point, very few have used repeated measures outcome data to describe how these inequalities emerge. Our aims were to describe social inequalities in child internalising and externalising problems across multiple countries and to explore how these inequalities change as children age.MethodsWe used longitudinal data from eight birth cohorts containing participants from twelve countries (Australia, Belgium, Denmark, France, Germany, Greece, Italy, Netherlands, Poland, Norway, Spain and the United Kingdom). The number of included children in each cohort ranged from N = 584 (Greece) to N = 73,042 (Norway), with a total sample of N = 149,604. Child socio‐economic circumstances (SEC) were measured using self‐reported maternal education at birth. Child mental health outcomes were internalising and externalising problems measured using either the Strengths and Difficulties Questionnaire or the Child Behavior Checklist. The number of data collection waves in each cohort ranged from two to seven, with the mean child age ranging from two to eighteen years old. We modelled the slope index of inequality (SII) using sex‐stratified multi‐level models.ResultsFor almost all cohorts, at the earliest age of measurement children born into more deprived SECs had higher internalising and externalising scores than children born to less deprived SECs. For example, in Norway at age 2 years, boys born to mothers of lower education had an estimated 0.3 (95% CI 0.3, 0.4) standard deviation higher levels of internalising problems (SII) compared to children born to mothers with high education. The exceptions were for boys in Australia (age 2) and both sexes in Greece (age 6), where we observed minimal social inequalities. In UK, Denmark and Netherlands inequalities decreased as children aged, however for other countries (France, Norway, Australia and Crete) inequalities were heterogeneous depending on child sex and outcome. For all countries except France inequalities remained at the oldest point of measurement.ConclusionsSocial inequalities in internalising and externalising problems were evident across a range of EU countries, with inequalities emerging early and generally persisting throughout childhood.

The association of multi-system conditions on mental health trajectories during naval deployment

ABSTRACT This study seeks to enhance understanding of mental health trajectories across Navy deployments and the predictors of those trajectories by exploring a range of job design and individual-level factors. Personnel from the Royal Australian Navy were surveyed on pre-deployment, mid-deployment, and post-deployment. At pre-deployment, there were 559 (M age = 30.19; male = 75.5%) survey responses, N = 112 survey responses could be linked at all time points (retention rate of 20.04% across all time points), and 314 personnel (56.2%) responded at least twice. Latent class growth analyses and growth mixture models were used to determine the trajectories that best fit the data. Separate models were developed for each of the mental health outcomes studied (i.e. psychological distress, perceived resilience, and perceived stress), plus a latent outcome representing a summary measure of psychological ill-health. This latent outcome, estimated as the most comprehensive assessment approach, was used to evaluate all 33 predictors. Consistent with previous work, we identified between two and four trajectories reflecting resilient/low symptom trajectories and heterogeneous symptom trajectories. There were a greater proportion of personnel in the heterogeneous symptom trajectories than identified in previous research. A key contribution of this work is the thorough comparison and ranking of factors that influence the deployment experience. We emphasize the importance of role demands and resources in determining these trajectories when compared directly to self-regulation strategies. Study findings highlight important implications for job design for military personnel during deployment and underscore the importance of adopting a holistic system approach to well-being.

Family functioning and child internalizing and externalizing problems: A 16-wave longitudinal study during the COVID-19 pandemic.

This study explored young children's mental health trajectories during the pandemic (May 2020 to April 2021) as well as associations with family functioning (i.e., cohesion, conflict, chaos, and routines) using data reported by 204 parents (children Mage 5.49; 45% girls, 90% White). Children's internalizing problems decreased early on with the onset of the pandemic, but then leveled off, while no change in externalizing problems was found. Family conflict and chaos were significantly associated with internalizing and externalizing problems at the within- and between-family level, when examined independently. When family-level factors were evaluated simultaneously, family conflict emerged as a robust risk factor. Intervention efforts, specifically for families experiencing increased conflict, may help support the mental health needs of children.

A systematic review of individual, social, and societal resilience factors in response to societal challenges and crises

Societal challenges put public mental health at risk and result in a growing interest in resilience as trajectories of good mental health during stressor exposure. Resilience factors represent multilevel psychosocial resources that increase the likelihood of resilient responses. This preregistered systematic review aims at summarizing evidence on the predictive value of individual, social and societal resilience factors for resilient responses to societal challenges and crises. Eligible studies examined the predictive value of resilience factors in stressor-exposed populations in high-income countries by means of multinomial regression models based on growth mixture modeling. Five databases were searched until August 2, 2023. Data synthesis employed a rating scheme to assess the incremental predictive value of resilience factors beyond sociodemographic variables and other resilience factors. An adapted version of the Newcastle-Ottawa Scale was used for risk of bias assessment. Fifty studies (sample sizes: 360–65,818 participants) with moderate study quality reported on various stressors (e.g., pandemics, natural disasters, terrorist attacks). Higher income, socioeconomic status and perceived social support, better emotion regulation and psychological flexibility were related to more resilient responses. The association between resilience factors and resilient responses was stronger in samples with younger mean age and a larger proportion of women. Most studies used non-representative convenience samples and effects were smaller when accounting for sociodemographic variables and other resilience factors. For many factors, findings were mixed, supporting the importance of the fit between resilience factors and situational demands. Research into social and societal resilience factors and multilevel resilience interventions is needed. Preregistration-ID: 10.17605/OSF.IO/GWJVA. Funding source: Robert Koch Institute (ID: LIR_2023_01).

Supporting mental health in farming communities where and when it is needed most: A longitudinal analysis of risk and protective factors

The cyclical nature of agriculture exposes farmers to challenges that vary over time, influenced by a myriad of external factors beyond their control. This longitudinal study aimed to examine mental health trajectories for Western Australian farmers over a 12 month period, and determine associations with key risk and protective factors. Farmers and farm residents (N = 125) completed an online survey at three timepoints (baseline, 6 months and 12 months) that assessed anxiety, depression, stress, farming stressors, coping strategies, sense of belonging and social supports. Survey timing coincided with periods of harvest and seeding. Risk factors associated with poorer mental health among farmers included a range of dysfunctional and emotion coping strategies, family/relationship stressors, financial/external stressors and daily stressors. Protective factors included sense of belonging and social support. Stress was found to change over time and family/relationship stressors and financial/external stressors at baseline were found to moderate anxiety and stress at 6 months and 12 months. Addressing factors associated with poor mental health trajectories and bolstering factors that are protective for mental health over time will aid clinical and community services in tailoring their services to meet the needs of farmers.

Polycyclic aromatic hydrocarbon exposure effects on trajectories of maternal and adolescent mental health

BackgroundParental psychological distress is a well-known risk factor for developmental psychopathology, with longer term parental distress associated with worse youth mental health. Neurotoxicant exposure during pregnancy is a risk factor for both poor maternal and youth mental health. The impact of one class of pollutant, polycyclic aromatic hydrocarbons (PAH), on long-term trajectories of maternal distress and youth self-reported mental health symptoms in adolescence has been understudied.MethodsPAH exposure was measured by DNA adducts in maternal blood sampled during the third trimester of pregnancy. Maternal distress, operationalized as maternal demoralization, was measured at 11 timepoints (prenatal to child age 16). Adolescent mental health symptoms were measured at age 13–15. Follow up analyses examined a subset of measures available at age 15–20 years. Structural equation modeling examined associations between PAH exposure during pregnancy and latent growth metrics of maternal distress, and between maternal distress (intercept and slope) and youth mental health symptoms in a prospective longitudinal birth cohort (N = 564 dyads).ResultsHigher prenatal PAH exposure was associated with higher concurrent maternal distress. Prenatal maternal distress was associated with adolescent’s self-reported anxiety, depression, and externalizing problems. On average, maternal distress declined over time; a slower decline in mother’s distress across the course of the child’s life was associated with greater self-reported anxiety and externalizing problems in youth.ConclusionsOur findings are consistent with an intergenerational framework of environmental effects on mental health: PAH exposure during pregnancy affects maternal mental health, which in turn influences mental health outcomes for youth well into adolescence. Future research is necessary to elucidate the possible social and biological mechanisms (e.g., parenting, epigenetics) underlying the intergenerational transmission of the negative effects of pollution on mental health in caregiver-child dyads.

A Prospective Examination of Mental Health Trajectories of Disaster-Exposed Young Adults in the COVID-19 Pandemic.

This longitudinal study examines young adult mental health (MH) trajectories after exposure to natural disasters (i.e., hurricanes, wildfires, mudslides) across four waves, two pre- and two during the COVID-19 pandemic. Participants (n = 205) answered questions about anxiety, depression, and post-traumatic stress symptoms (PTSSs) across Waves (Ws) s 1-4 and pre-pandemic factors (prior trauma history, disaster exposure, life stressors since disaster) at Wave (W) 1. Hierarchical linear modeling was conducted to examine MH trajectories and associations with pre-pandemic factors. Only the PTSS trajectory significantly differed across all Ws, with the largest increase between Ws 2 and 3 (pre- and during-pandemic time points). Prior trauma history and life stressors since the disaster were significantly associated with all MH trajectory intercepts but not growth rates.

Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic-A longitudinal investigation of mental health trajectories.

The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The course of children's mental health symptoms during and beyond the COVID-19 pandemic.

The COVID-19 pandemic is associated with increases in child mental health problems, but the persistence of these changes in the post-pandemic era remains uncertain. Additionally, it is unclear whether changes in mental health problems during the pandemic exceed the anticipated increases as children age. This study controls for the linear effect of age in 1399 children, investigating the course of child-reported anxiety, depression, hyperactivity, and inattention symptoms during and after the pandemic, and identifies risk and protective factors that predict these mental health trajectories. Children (51% male; ages 9-11 at the first timepoint) provided mental health ratings at three pandemic timepoints (July-August 2020; March-April 2021; November 2021-January 2022) and one post-pandemic timepoint (January-July 2023). Mothers reported pre-pandemic mental health (2017-2019) and socio-demographic factors. Children reported socio-demographic factors, risk (e.g. screen time, sleep), and resilience (e.g. optimism) factors during the first timepoint. Average mental health symptoms increased over time, with more children exceeding clinical cut-offs for poor mental health at each subsequent pandemic timepoint. Growth curve modeling, adjusting for age-related effects, revealed a curvilinear course of mental health symptoms across all domains. Examination of risk and protective factors revealed that pre-existing mental health symptoms and optimism were associated with the course of symptoms. After considering age effects, children's mental health follows a curvilinear pattern over time, suggesting an initial decline followed by a rising trend in symptoms post-COVID. These findings underscore the continued need for additional resources and timely, evidence-based mental health prevention and intervention for children.

Evaluation of Anxiety and Depression Among Orphan and Non-Orphan Adolescents in a Rural Residential School of Maharashtra

Abstract Background: Adolescence marks a critical stage of development characterized by profound physical, emotional, and social changes. This study explores the prevalence of anxiety and depression among orphan and non-orphan adolescents in a rural residential school setting, aiming to identify associated factors. Method: A community-based cross-sectional descriptive study was conducted among 100 adolescents (50 orphans and 50 non-orphans) aged 10-19 years in Warudi, Jalna from August 10 to October 10, 2022. Institutional ethical approval and written informed consent were obtained. Data collection included DSM-5 criteria for anxiety and depression assessment, using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HDRS). Additional parameters assessed were sleep disturbances, academic performance, social interactions, duration of stay in the residential school, and type of orphanhood. Statistical analysis was performed using SPSS version 21, with qualitative parameters presented as percentages and the chi-square test used for comparisons (p&lt;0.05 considered significant). Result: The study revealed notable disparities in mental health outcomes between orphan and non-orphan adolescents. Orphans, predominantly categorized as double orphans (54%), exhibited higher prevalence rates of anxiety (46%) and depression (30%) compared to non-orphans (anxiety 14%, depression 12%). Factors such as prolonged stays in residential schools and the duration of orphanhood were significantly associated with heightened levels of anxiety and depression among orphans. Conclusion: Orphan adolescents residing in rural residential school face significantly elevated risks of anxiety and depression compared to their non-orphan peers. The findings highlight the urgent need for targeted psychological support and interventions tailored to the unique challenges of orphanhood, including the prolonged institutional care and the emotional impact of parental loss. Future research should focus on longitudinal studies to assess the effectiveness of interventions and track mental health trajectories over time.

Mental health disparities among first generation immigrants to the US

Mental health disparities among first-generation immigrants to the United States are intricately linked to the historical and sociopolitical context of immigration. The Immigration and Nationality Act of 1965 and policies such as Deferred Action for Childhood Arrivals (DACA) have shaped the demographic and experiential landscape of first-generation immigrants, influencing their mental health outcomes. Objective: This study aims to examine the mental health disparities experienced by first-generation immigrants in the United States, identifying the contributing factors and exploring effective strategies for addressing these disparities. Methods: A comprehensive literature review was conducted, analyzing studies on mental health outcomes among first-generation immigrants. The review focused on factors contributing to mental health disparities, including pre-migration experiences, migration-related stressors, post-migration challenges, and systemic barriers to mental health care access. The review also explored intersectionality and its impact on mental health, as well as case studies and examples of successful interventions. Results: The "immigrant paradox" suggests that immigrants often exhibit better mental health outcomes than native-born individuals, though this effect diminishes over time. Factors such as strong family ties and community support initially contribute to this mental health advantage. However, post-migration challenges, including acculturation stress, socioeconomic hardship, and discrimination, often lead to a decline in mental health. Certain mental health conditions, such as PTSD and anxiety disorders, are more prevalent among specific immigrant groups, particularly those fleeing conflict or persecution. Structural, cultural, and systemic barriers hinder access to mental health care, exacerbating disparities. Successful interventions often involve community-based approaches, culturally competent care, and integrated service models. Conclusion: Addressing mental health disparities among first-generation immigrants requires a multifaceted approach, including community engagement, policy interventions, and culturally competent care. By investing in research and implementing evidence-based interventions, it is possible to reduce mental health disparities and improve outcomes for first-generation immigrants. Future research should focus on long-term mental health trajectories, the impact of digital technologies, and the role of social networks.