Positive functioning as an outcome in its own right.
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5701 to 5725 of 6,178"Where are all the lonely people?" A population-based study of high-risk groups across the life span.
Background: Loneliness is a prevalent and urgent public health issue. Optimal planning of community approaches to loneliness requires a differentiated understanding of loneliness across the life span. We identified groups at high risk of loneliness by exploring the relationship between loneliness and socio-demographic and health-related factors across multiple age groups.
Methods: This was a combined population-based questionnaire survey and register data study based on a representative sample, including 33,285 Danish individuals aged 16-102 years. Loneliness was measured using the Three-Item Loneliness Scale.
Results: The relation between loneliness and age took a shallow U-shaped distribution. Ethnic minority status, receiving disability pensions or being unemployed, living alone, prolonged mental disorder, and psychiatric treatment were strongly associated with severe loneliness. Soci…
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National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults.
Objectives: This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014.
Methods: Data were drawn from the National Surveys on Drug Use and Health for 2005 to 2014, which are annual cross-sectional surveys of the US general population. Participants included 172 495 adolescents aged 12 to 17 and 178 755 adults aged 18 to 25. Time trends in 12-month prevalence of MDEs were examined overall and in different subgroups, as were time trends in the use of treatment services.
Results: The 12-month prevalence of MDEs increased from 8.7% in 2005 to 11.3% in 2014 in adolescents and from 8.8% to 9.6% in young adults (both P < .001). The increase was larger and statistically significant only in the age range of 12 to 20 ye…
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Loneliness over time: The crucial role of social anxiety.
Loneliness is known to be associated with multiple adverse physical outcomes, including higher mortality and morbidity risk. However, the impact of loneliness on mental health is less well researched, with most studies assessing how loneliness relates to depressive symptoms alone. We hypothesized that 2 mental health symptoms that relate to the fear of others-social anxiety and paranoia-would contribute to loneliness. We examined how loneliness relates to social anxiety, paranoia, and depression symptoms in a general community sample aged 18-87 years old (N = 1,010). We administered online measures over 3 time points across a 6-month period. In a cross-lagged structural equation model controlling for trait levels and prior states, our results indicated that earlier loneliness positively predicted future states of social anxiety, paranoia, and depression. However, in the same model, earli…
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Adverse childhood experiences, health, and employment: A study of men seeking job services.
The present study explored factors associated with barriers to current employment among 199 low-income, primarily Black American men seeking job services. The study took place in an urban setting located within the upper Midwest region of the U.S., where the problem of Black male joblessness is both longstanding and widespread. Recent research suggests that Black male joblessness regionally and nationally is attributable to myriad macro- and micro-level forces. While structural-level factors such as migration of available jobs, incarceration patterns, and racism have been relatively well-studied, less is known about individual-level predictors of Black male joblessness, which are inextricably linked to macro-level or structural barriers. This study therefore examined relations between adverse childhood experiences (ACEs), health-related factors, and employment-related problems. Participa…
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Stressful life events and leucocyte telomere length: Do lifestyle factors, somatic and mental health, or low grade inflammation mediate this relationship? Results from a cohort of Danish men born in 1953.
Exposure to psychosocial stress is associated with increased risk of a number of somatic and mental disorders with relation to immune system functioning. We aimed to explore whether stressful events in early and recent life was associated with leucocyte telomere length (TL), which is assumed to reflect the accumulated burden of inflammation and oxidative stress occurring during the life course. We specifically aimed to address whether childhood constitutes a sensitive period and how much of the relation between stressful life events and TL is mediated through somatic and mental health, lifestyle, and markers of low-grade inflammation. A cohort of Danish men born in 1953 has been followed since birth in the Metropolit Cohort. These men underwent a health examination including blood sampling in 2010 and a subset of 324 also had a quantitative PCR-based measurement of TL. The relation betwe…
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Consistency in adult reporting of adverse childhood experiences.
Background: Many studies have used retrospective reports to assess the long-term consequences of early life stress. However, current individual characteristics and experiences may bias the recall of these reports. In particular, depressed mood may increase the likelihood of recall of negative experiences. The aim of the study was to assess whether specific factors are associated with consistency in the reporting of childhood adverse experiences.
Method: The sample comprised 7466 adults from Canada's National Population Health Survey who had reported on seven childhood adverse experiences in 1994/1995 and 2006/2007. Logistic regression was used to explore differences between those who consistently reported adverse experiences and those whose reports were inconsistent.
Results: Among those retrospectively reporting on childhood traumatic experiences in 1994/1995 and 2006/2007, 39% were inc…
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A qualitative exploration of the emotional wellbeing and support needs of new mothers from Afghanistan living in Melbourne, Australia.
Background: The Afghan community is a priority population for many health and social services within the southeast region of Melbourne, which is home to the largest population of Afghanistan-born people within the state of Victoria. The majority of Afghan women arriving in Australia are of childbearing age, and evidence suggests that they are at increased risk of emotional challenges following birth as a result of the refugee and migration experience. This research aimed to explored the experiences of Afghan women living in Melbourne throughout pregnancy, birth, and early motherhood, and gain insight into the aspects of their experiences that they perceive as positively and negatively impacting their emotional wellbeing.
Methods: This qualitative study collected data through two focus group discussions (conducted in Dari) and 10 in-depth interviews (conducted in Dari or English). Thirty-…
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Challenges in researching migration status, health and health service use: an intersectional analysis of a South London community.
Objectives: This study aimed to investigate the associations between migration status and health-related outcomes and to examine whether and how the effect of migration status changes when it is disaggregated by length of residence, first language, reason for migration and combined with ethnicity.
Design: A total of 1698 adults were interviewed from 1076 randomly selected households in two South London boroughs. We described the socio-demographic and socio-economic differences between migrants and non-migrants and compared the prevalence of health-related outcomes by migration status, length of residence, first language, reason for migration and migration status within ethnic groups. Unadjusted models and models adjusted for socio-demographic and socio-economic indicators are presented.
Results: Migrants were disadvantaged in terms of socio-economic status but few differences were found …
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Kiss L, Pocock NS, Naisanguansri V, Suos S, Dickson B, Thuy D, Koehler J, Sirisup K, Pongrungsee N, Nguyen VA, Borland R, Dhavan P, Zimmerman C (2015)MEDLINE-indexed journal, not yet read by usThe Lancet. Global health87 citations Health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam: an observational cross-sectional study.
Background: Trafficking is a crime of global proportions involving extreme forms of exploitation and abuse. Yet little research has been done of the health risks and morbidity patterns for men, women, and children trafficked for various forms of forced labour.
Methods: We carried out face-to-face interviews with a consecutive sample of individuals entering 15 post-trafficking services in Cambodia, Thailand, and Vietnam. We asked participants about living and working conditions, experience of violence, and health outcomes. We measured symptoms of anxiety and depression with the Hopkins Symptoms Checklist and post-traumatic stress disorder with the Harvard Trauma Questionnaire, and used adjusted logistic regression models to estimate the effect of trafficking on these mental health outcomes, controlling for age, sector of exploitation, and time in trafficking.
Findings: We interviewed 1102…
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Health and writing: meaning-making processes in the narratives of parents of children with leukemia.
There is literary evidence stating that expressive writing affects health outcomes. Nevertheless, the processes underlying its benefits remain unclear. In our previous article, we described the benefits of writing; in this article, we investigate the meaning-making processes underlying the traumatic experiences of parents of children with leukemia in off-therapy. We collected the writings of 23 parents and grouped them according to the parents' psychological outcome (low/good/high) with respect to anxiety, as assessed during a follow-up. We qualitatively analyzed the texts written by parents with good psychological outcomes to highlight their main meaning-making processes, that is, how they put into words the shattering experience, reordered the events, connected their emotions and the events, reevaluated the event, and reconstructed the time process. We found that parents with low/high …
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It's Not About "Freudian Couches and Personality Changing Drugs": An Investigation Into Men's Mental Health Help-Seeking Enablers.
Enabling factors that influenced men to seek assistance for mental health concerns--a previous underresearched area--was the primary focus of this research. Past research spanning four decades has focused on men's barriers to mental health help-seeking with limited research positing social norms within men's peer groups and reciprocity as potential mental health help-seeking enablers. Using a qualitative design, nine men were interviewed to identify the positive factors they believed assisted their help-seeking decisions. Social norms, reciprocity, a significant other, and helpfulness of their general practitioner were domains identified in the analysis of participant narratives. The study revealed the participants' mental health and treatment illiteracy. Ignorance and misplaced stereotypes, initially acted as barriers to help-seeking, leading to denial of illness, impeding treatment, an…
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The gender gap in mental health service use.
Purpose: This study examines why men engage less in mental health service use, by studying how gender is performed in interactions, following the doing gender perspective. We hypothesize that seeking help for mental illness may constitute a gendered role conflict among men since help seeking is associated with femininity. Therefore, we expect that men will recommend reliance on self-care options to other men, and in cases in which professional treatment is recommended, they will prefer medication to psychotherapy. We also expect that men will report greater stigmatizing attitudes.
Methods: The survey Stigma in a Global Context-Belgian Mental Health Study (2009) conducted interviews of a representative sample of the Belgian general population (N = 743). The vignette technique, depicting depressive and schizophrenic symptoms, was used. Multiple linear and logistic models were estimated in …
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Substance use and treatment of substance use disorders in a community sample of transgender adults.
Background: Transgender people have elevated substance use prevalence compared with the U.S. general population, however no studies have comprehensively examined the relationship of psychosocial risk factors to substance use and substance use disorder (SUD) treatment among both male-to-female (MTF) and female-to-male (FTM) transgender adults.
Methods: Secondary data analysis of a 2013 community-based survey of transgender adults in Massachusetts (N=452) was conducted. Adjusted multivariable logistic regression models were fit to examine the relationship of four risk factor domains with SUD treatment history and recent substance use: (1) demographics; (2) gender-related characteristics; (3) mental health; (4) socio-structural factors. Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (95% CI) were estimated.
Results: Ten percent of the sample reported lifetime SUD treatment. Factors…
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Psychological resilience after Hurricane Sandy: the influence of individual- and community-level factors on mental health after a large-scale natural disaster.
Several individual-level factors are known to promote psychological resilience in the aftermath of disasters. Far less is known about the role of community-level factors in shaping postdisaster mental health. The purpose of this study was to explore the influence of both individual- and community-level factors on resilience after Hurricane Sandy. A representative sample of household residents (N = 418) from 293 New York City census tracts that were most heavily affected by the storm completed telephone interviews approximately 13-16 months postdisaster. Multilevel multivariable models explored the independent and interactive contributions of individual- and community-level factors to posttraumatic stress and depression symptoms. At the individual-level, having experienced or witnessed any lifetime traumatic event was significantly associated with higher depression and posttraumatic stres…
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A relational model of sexual minority mental and physical health: The negative effects of shame on relationships, loneliness, and health.
Sexual minorities (e.g., lesbians, gay men, bisexual individuals) are at an increased risk for poorer mental and physical health outcomes than heterosexuals, and some of these health disparities relate to minority stressors such as discrimination. Yet, there is little research elucidating pathways that predict health or that promote resiliency among sexual minorities. Building on the minority stress model, the present study utilized relational cultural theory to situate sexual minority health within a relational framework. Specifically, the study tested mediators of the relationships between distal (i.e., discrimination, rejection, victimization) and proximal stressors (i.e., internalized homophobia, sexual orientation concealment) and psychological and physical distress for sexual minorities. Among 719 sexual minority adults, structural equation modeling analyses were used to test 4 mod…
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Freeman D, Sheaves B, Goodwin GM, Yu LM, Harrison PJ, Emsley R, Bostock S, Foster RG, Wadekar V, Hinds C, Espie CA (2015)MEDLINE-indexed journal, not yet read by usTrials25 citations Effects of cognitive behavioural therapy for insomnia on the mental health of university students: study protocol for a randomized controlled trial.
Background: Insomnia, defined as repeated difficulties getting or staying asleep, is common in the general population. Such sleep difficulties are a problem in their own right, but increasingly it is being recognised that they may also be a contributory factor in the development of a wide range of mental health problems. Our focus is upon the relationship between insomnia and psychotic experiences, such as paranoia and hallucinations. Psychotic experiences commonly occur in mild forms in the general population and have been linked to disrupted sleep. These psychotic-like experiences raise the risk of development of a clinical disorder. Our aim is to reduce insomnia in a large general population group, and examine the effect on paranoia and hallucinations at the age when mental health problems typically emerge. The primary hypotheses are that cognitive behaviour therapy (CBT) for insomnia…
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Socioeconomic Associations with ADHD: Findings from a Mediation Analysis.
Background: Children from disadvantaged socioeconomic backgrounds are at greater risk of a range of negative outcomes throughout their life course than their peers; however the specific mechanisms by which socioeconomic status relates to different health outcomes in childhood are as yet unclear.
Aims: The current study investigates the relationship between socioeconomic disadvantage in childhood and attention deficit/hyperactivity disorder (ADHD), and investigates putative mediators of this association in a longitudinal population-based birth cohort in the UK.
Methods: Data from the Avon Longitudinal Study of Parents and Children was used (n = 8,132) to explore the relationship between different measures of socioeconomic status at birth-3 years and their association with a diagnosis of ADHD at age 7. A multiple mediation model was utilised to examine factors occurring between these ages …
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Couples and Miscarriage: The Influence of Gender and Reproductive Factors on the Impact of Miscarriage.
Objective: We sought to understand the effect of gender, age, mental health history, and reproductive factors on the appraisal of miscarriage in couples.
Design: We conducted a secondary analysis of data from the Couples Miscarriage Healing Project.
Sample: We analyzed data from 341 couples who had miscarried within 3 months of the original study recruitment.
Method: Multifactorial analysis of variance was used to analyze baseline effects of gender, age, mental health history, infertility, number of miscarriages, living children, and gestational age on the impact of miscarriage as measured by the three subscales of the Revised Impact of Miscarriage Scale: Isolation/Guilt, Devastating Event, and Loss of Baby.
Results: Women scored significantly higher than men on all measures. Younger couples in whom either member had been previously treated for anxiety, depression, or grief were more lik…
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Cognitive-behavioral variables mediate the impact of violent loss on post-loss psychopathology.
Research has shown that violent losses lead to more severe emotional distress than do nonviolent losses. Little is known about the psychological mechanisms underlying the debilitating impact of violent loss. In the current study, the authors used self-reported data of 496 bereaved individuals, bereaved in the last 3 years, to examine the role of seven cognitive-behavioral variables in mediating the impact of violent loss: (a) a sense of "unrealness" about the irreversibility of the separation, negative cognitions about (b) the self, (c) life, (d) the future, and (e) catastrophic misinterpretations of grief-reactions, and indices of (f) anxious avoidance and (g) depressive avoidance behavior. Outcomes showed that people bereaved by violent losses (due to homicide, suicide, or accident) had significantly higher symptom-levels of Prolonged Grief Disorder (PGD), posttraumatic stress disorder…
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Early Social-Emotional Functioning and Public Health: The Relationship Between Kindergarten Social Competence and Future Wellness.
Objectives: We examined whether kindergarten teachers' ratings of children's prosocial skills, an indicator of noncognitive ability at school entry, predict key adolescent and adult outcomes. Our goal was to determine unique associations over and above other important child, family, and contextual characteristics.
Methods: Data came from the Fast Track study of low-socioeconomic status neighborhoods in 3 cities and 1 rural setting. We assessed associations between measured outcomes in kindergarten and outcomes 13 to 19 years later (1991-2000). Models included numerous control variables representing characteristics of the child, family, and context, enabling us to explore the unique contributions among predictors.
Results: We found statistically significant associations between measured social-emotional skills in kindergarten and key young adult outcomes across multiple domains of educati…
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Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing.
Introduction: An increasing number of grandparents in rural USA are serving as primary caregivers for their grandchildren because of parental incarceration, addiction, joblessness, or illness. Low-income, African American women from the South are overrepresented in this growing population. There is a paucity of research exploring the challenges faced by rural grandparent caregivers, and past studies have not explicitly addressed the potential consequences of rural grandparent caregiving for health. The purpose of this qualitative study was to explore grandparent caregiving among rural, low-income, African American grandmothers in a community in the American South, and to identify challenges to health that arose in that context. McLeroy's social ecological model (SEM) was used to examine these challenges at multiple levels of influence.
Methods: This qualitative interview-based study was …
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Marriage, Relationship Quality, and Sleep among U.S. Older Adults.
Sleep is a restorative behavior essential for health. Poor sleep has been linked to adverse health outcomes among older adults; however, we know little about the social processes that affect sleep. Using innovative actigraphy data from the National Social Life, Health, and Aging Project (N = 727), we considered the role of marriage, positive marital relationship support, and negative marital relationship strain on older adults' (ages 62-90) self-reported and actigraph-measured sleep characteristics. We found that married older adults had better actigraph-estimated but not self-reported sleep characteristics than the unmarried. However, among the married, those who reported more negative aspects of their marital relationship reported more insomnia symptoms, with the association reduced when psychosocial characteristics were added to the model. The married who reported more positive aspect…
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Help Seeking Attitudes Among Cambodian and Laotian Refugees: Implications for Public Mental Health Approaches.
This is a pilot study of demographic and acculturation factors in relation to attitudes toward seeking psychological help among Lao and Cambodian refugees and immigrants in the United States of America. Cambodian and Laotian American adults in the United States of America were approached to complete help-seeking attitudes and acculturation scales. T test and hierarchical multiple regression analyses were used to analyze the relationships between the demographic and acculturation variables, and attitudes toward seeking psychological help. Out of 270 target subjects approached there were 108 respondents. Of the demographic variables, gender was associated with favorable attitudes towards psychological help-seeking. As expected, women were significantly more likely than men to recognize the need for help, to seek psychological help, to be more open to discussing mental health problems, and …
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The intersections of culture and power in clinician and interpreter relationships: A qualitative study.
Ongoing racial/ethnic health disparities place increasing emphasis on the importance of interpreters in mental health treatment. Yet there is a limited body of research examining how interpreters and clinicians work together in delivering care. This article used an ethno-culturally informed qualitative procedure to ask interpreters and clinicians about their experiences in cross-language mental health treatment. Seventeen semistructured interviews were conducted with 10 interpreters and 7 clinicians. The interplay of power was experienced differently by interpreters and clinicians as exemplified by 3 categories of meaning: Interpreters speaking out, The relationship matters, and Who has the power? The authors recommend future research focus on the clinician-interpreter relationship as an essential piece of cross-cultural mental health delivery.
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Impacts of family and community violence exposure on child coping and mental health.
An ecological stress process model was employed to explore relations between children's exposures to family and community violence and child mental health, and emotionally-regulated coping (ERC) as a protective factor among Latino, European-American, and African-American school-aged children (n = 91; girls, n = 50[54 %]) living in single-parent families who were either homeless and residing in emergency shelters or housed but living in poverty. Mothers reported domestic violence experiences and their child's history of physical/sexual abuse, community violence exposures, and mental health. Children reported on exposure to community violence, internalizing symptoms, and coping. The mental health impacts of multi-level violence exposures and ERC as a moderator of associations between violence exposures and child mental health was tested with structural equation modeling. Family abuse was u…
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