Bach, Bo; Sellbom, Martin; Skjernov, Mathias; Simonsen, Erik
2018-05-01
The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive-compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. These preliminary findings suggest that little information is 'lost' in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain 'cross walk' is provided in the article.
Oliveira, Sandra E H; Carvalho, Helena; Esteves, Francisco
2016-01-01
People with mental illness who internalize stigma often experience reduced self-esteem and impaired quality of life (QOL). To propose a theoretical model in which self-esteem mediates the effects of internalized stigma on the multidimensional domains comprising QOL. In 403 inpatients and outpatients (DSM-IV, American Psychiatric Association, 1994), from hospital-based and community mental health facilities, self-report measures of internalized stigma (ISMI), self-esteem (RSES) and QOL (WHOQOL-Bref) were administrated. Structural equation modeling results supported the proposed model. Self-esteem fully mediated the relation between internalized stigma and the physical and the social relationships domains, and partially mediated the relationship between internalized stigma and psychological, environment and level of independence QOL domains. Such results provided empirical support and shed light upon previous research. Specifically the results emphasize the mediating role that self-esteem plays in the degree to which internalized stigma exerts a negative effect on specific QOL domains. Self-esteem appears to be a core element in reducing the negative effects of internalized stigma on aspects of QOL among people with mental illness. These findings suggest there is a crucial impact regarding clinical mental health interventions along with important theoretical implications.
Almansa, Josué; Vermunt, Jeroen K; Forero, Carlos G; Vilagut, Gemma; De Graaf, Ron; De Girolamo, Giovanni; Alonso, Jordi
2011-06-01
Epidemiological studies on mental health and mental comorbidity are usually based on prevalences and correlations between disorders, or some other form of bivariate clustering of disorders. In this paper, we propose a Factor Mixture Model (FMM) methodology based on conceptual models aiming to measure and summarize distinctive disorder information in the internalizing and externalizing dimensions. This methodology includes explicit modelling of subpopulations with and without 12 month disorders ("ill" and "healthy") by means of latent classes, as well as assessment of model invariance and estimation of dimensional scores. We applied this methodology with an internalizing/externalizing two-factor model, to a representative sample gathered in the European Study of the Epidemiology of Mental Disorders (ESEMeD) study -- which includes 8796 individuals from six countries, and used the CIDI 3.0 instrument for disorder assessment. Results revealed that southern European countries have significantly higher mental health levels concerning internalizing/externalizing disorders than central countries; males suffered more externalizing disorders than women did, and conversely, internalizing disorders were more frequent in women. Differences in mental-health level between socio-demographic groups were due to different proportions of healthy and ill individuals and, noticeably, to the ameliorating influence of marital status on severity. An advantage of latent model-based scores is that the inclusion of additional mental-health dimensional information -- other than diagnostic data -- allows for greater precision within a target range of scores. Copyright © 2011 John Wiley & Sons, Ltd.
The cross-national structure of mental disorders: results from the World Mental Health Surveys.
de Jonge, Peter; Wardenaar, Klaas J; Lim, Carmen C W; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Bunting, Brendan; Chatterji, Somnath; Ciutan, Marius; Gureje, Oye; Karam, Elie G; Lee, Sing; Medina-Mora, Maria Elena; Moskalewicz, Jacek; Navarro-Mateu, Fernando; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Torres, Yolanda; Kessler, Ronald C; Scott, Kate
2017-12-19
The patterns of comorbidity among mental disorders have led researchers to model the underlying structure of psychopathology. While studies have suggested a structure including internalizing and externalizing disorders, less is known with regard to the cross-national stability of this model. Moreover, little data are available on the placement of eating disorders, bipolar disorder and psychotic experiences (PEs) in this structure. We evaluated the structure of mental disorders with data from the World Health Organization Composite International Diagnostic Interview, including 15 lifetime mental disorders and six PEs. Respondents (n = 5478-15 499) were included from 10 high-, middle- and lower middle-income countries across the world aged 18 years or older. Confirmatory factor analyses (CFAs) were used to evaluate and compare the fit of different factor structures to the lifetime disorder data. Measurement invariance was evaluated with multigroup CFA (MG-CFA). A second-order model with internalizing and externalizing factors and fear and distress subfactors best described the structure of common mental disorders. MG-CFA showed that this model was stable across countries. Of the uncommon disorders, bipolar disorder and eating disorder were best grouped with the internalizing factor, and PEs with a separate factor. These results indicate that cross-national patterns of lifetime common mental-disorder comorbidity can be explained with a second-order underlying structure that is stable across countries and can be extended to also cover less common mental disorders.
Laceulle, Odilia M; Ormel, Johan; Vollebergh, Wilma A M; van Aken, Marcel A G; Nederhof, Esther
2014-03-01
This study aimed to test the vulnerability model of the relationship between temperament and mental disorders using a large sample of adolescents from the TRacking Adolescents Individual Lives' Survey (TRAILS). The vulnerability model argues that particular temperaments can place individuals at risk for the development of mental health problems. Importantly, the model may imply that not only baseline temperament predicts mental health problems prospectively, but additionally, that changes in temperament predict corresponding changes in risk for mental health problems. Data were used from 1195 TRAILS participants. Adolescent temperament was assessed both at age 11 and at age 16. Onset of mental disorders between age 16 and 19 was assessed at age 19, by means of the World Health Organization Composite International Diagnostic Interview (WHO CIDI). Results showed that temperament at age 11 predicted future mental disorders, thereby providing support for the vulnerability model. Moreover, temperament change predicted future mental disorders above and beyond the effect of basal temperament. For example, an increase in frustration increased the risk of mental disorders proportionally. This study confirms, and extends, the vulnerability model. Consequences of both temperament and temperament change were general (e.g., changes in frustration predicted both internalizing and externalizing disorders) as well as dimension specific (e.g., changes in fear predicted internalizing but not externalizing disorders). These findings confirm previous studies, which showed that mental disorders have both unique and shared underlying temperamental risk factors. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
ERIC Educational Resources Information Center
Schnotz, Wolfgang; Kurschner, Christian
2008-01-01
This article investigates whether different formats of visualizing information result in different mental models constructed in learning from pictures, whether the different mental models lead to different patterns of performance in subsequently presented tasks, and how these visualization effects can be modified by further external…
Evaluating Mental Models in Mathematics: A Comparison of Methods
ERIC Educational Resources Information Center
Gogus, Aytac
2013-01-01
Cognitive scientists investigate mental models (how humans organize and structure knowledge in their minds) so as to understand human understanding of and interactions with the world. Cognitive and mental model research is concerned with internal conceptual systems that are not easily or directly observable. The goal of this research was to…
Luo, Xiaohui; Wang, Hang; Fan, Yubo
2007-04-01
This study was aimed to develop a 3-D finite element (3-D FE) model of the mental fractured mandible and design the boundary constrains. The CT images from a health volunteer were used as the original information and put into ANSYS program to build a 3-D FE model. The model of the miniplate and screw which were used for the internal fixation was established by Pro/E. The boundary constrains of different muscle loadings were used to simulate the 3 functional conditions of the mandible. A 3-D FE model of mental fractured mandible under the miniplate-screw internal fixation system was constructed. And by the boundary constraints, the 3 biting conditions were simulated and the model could serve as a foundation on which to analyze the biomechanical behavior of the fractured mandible.
Siriwardhana, Chesmal; Stewart, Robert
2013-03-01
Forced internal displacement has been rising steadily, mainly due to conflict. Many internally displaced people (IDP) experience prolonged displacement. Global research evidence suggests that many of these IDP are at high risk for developing mental disorders, adding weight to the global burden of disease. However, individual and community resilience may act as protective factors. Return migration may be an option for some IDP populations, especially when conflicts end, although return migration may itself be associated with worse mental health. Limited evidence is available on effects of resettlement or return migration following prolonged forced internal displacement on mental health. Also, the role of resilience factors remains to be clarified following situations of prolonged displacement. The public health impact of internal displacement is not clearly understood. Epidemiological and interventional research in IDP mental health needs to look beyond medicalised models and encompass broader social and cultural aspects. The resilience factor should be integrated and explored more in mental health research among IDP and a clearly focused multidisciplinary approach is advocated.
Huppert, David; Griffiths, Matthew
2015-10-01
To review internationally recognized models of police interactions with people experiencing mental health crises that are sometimes complex and associated with adverse experience for the person in crisis, their family and emergency service personnel. To develop, implement and review a partnership model trial between mental health and emergency services that offers alternative response pathways with improved outcomes in care. Three unique models of police and mental health partnership in the USA were reviewed and used to develop the PACER (Police Ambulance Crisis Emergency Response) model. A three month trial of the model was implemented and evaluated. Significant improvements in response times, the interactions with and the outcomes for people in crisis were some of the benefits shown when compared with usual services. The pilot showed that a partnership involving mental health and police services in Melbourne, Australia could be replicated based on international models. Initial data supported improvements compared with usual care. Further data collection regarding usual care and this new model is required to confirm observed benefits. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Ensink, Karin; Bégin, Michaël; Normandin, Lina; Fonagy, Peter
2017-11-01
The objective was to examine pathways from child sexual abuse (CSA) and maternal mentalizing to child internalizing and externalizing difficulties and to test a model of MRF as a moderator of the relationships between CSA and child difficulties. The sample was comprised of 154 mothers and children aged 2-12 where 64 children had experienced CSA. To assess parental mentalizing the Parental Development Interview was rated with the Parental Reflective Functioning Scale. Child internalizing and externalizing difficulties were assessed with the Child Behavior Checklist (CBCL). Results indicate that there were significant inverse relationships between maternal mentalizing and child internalizing and externalizing difficulties. When maternal mentalizing was considered together with CSA, only maternal mentalizing was a significant predictor of child difficulties. Furthermore, maternal mentalizing moderated the relationship between CSA and child internalizing difficulties. These findings provide evidence of the importance of the parents' mentalizing stance for psychiatric symptoms of children aged 2-12, as well as children's recovery from CSA. The clinical implications of the findings are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.
Oudejans, S C C; Schippers, G M; Schramade, M H; Koeter, M W J; van den Brink, W
2011-04-01
To investigate internal consistency and factor structure of a questionnaire measuring learning capacity based on Senge's theory of the five disciplines of a learning organisation: Personal Mastery, Mental Models, Shared Vision, Team Learning, and Systems Thinking. Cross-sectional study. Substance-abuse treatment centres (SATCs) in The Netherlands. A total of 293 SATC employees from outpatient and inpatient treatment departments, financial and human resources departments. Psychometric properties of the Questionnaire for Learning Organizations (QLO), including factor structure, internal consistency, and interscale correlations. A five-factor model representing the five disciplines of Senge showed good fit. The scales for Personal Mastery, Shared Vision and Team Learning had good internal consistency, but the scales for Systems Thinking and Mental Models had low internal consistency. The proposed five-factor structure was confirmed in the QLO, which makes it a promising instrument to assess learning capacity in teams. The Systems Thinking and the Mental Models scales have to be revised. Future research should be aimed at testing criterion and discriminatory validity.
From Norm Adoption to Norm Internalization
NASA Astrophysics Data System (ADS)
Conte, Rosaria; Andrighetto, Giulia; Villatoro, Daniel
In this presentation, advances in modeling the mental dynamics of norms will be presented. In particular, the process from norm-adoption, possibly yielding new normative goals, to different forms of norm compliance will be focused upon, including norm internalization, which is at study in social-behavioral sciences and moral philosophy since long. Of late, the debate was revamped within the rationality approach pointing to the role of norm internalization as a less costly and more reliable enforcement system than social control. So far, poor attention was paid to the mental underpinnings of internalization. In this presentation, a rich cognitive model of different types, degrees and factors of internalization is shown. The initial implementation of this model on EMIL-A, a normative agent architecture developed and applied to the.
Kendler, Kenneth S.; Myers, John M.; Keyes, Corey L. M.
2012-01-01
To determine the relationship between the genetic and environmental risk factors for externalizing psychopathology and mental wellbeing, we examined detailed measures of emotional, social and psychological wellbeing, and a history of alcohol-related problems and smoking behavior in the last year in 1,386 individual twins from same-sex pairs from the MIDUS national US sample assessed in 1995. Cholesky decomposition analyses were performed with the Mx program. The best fit model contained one highly heritable common externalizing psychopathology factor for both substance use/abuse measures, and one strongly heritable common factor for the three wellbeing measures. Genetic and environmental risk factors for externalizing psychopathology were both negatively associated with levels of mental wellbeing and accounted for, respectively, 7% and 21% of its genetic and environmental influences. Adding internalizing psychopathology assessed in the last year to the model, genetic risk factors unique for externalizing psychopathology were now positively related to levels of mental wellbeing, although accounting for only 5% of the genetic variance. Environmental risk factors unique to externalizing psychopathology continued to be negatively associated with mental wellbeing, accounting for 26% of the environmental variance. When both internalizing psychopathology and externalizing psychopathology are associated with mental wellbeing, the strongest risk factors for low mental wellbeing are genetic factors that impact on both internalizing psychopathology and externalizing psychopathology, and environmental factors unique to externalizing psychopathology. In this model, genetic risk factors for externalizing psychopathology predict, albeit weakly, higher levels of mental wellbeing. PMID:22506307
Atri, Ashutosh; Sharma, Manoj; Cottrell, Randall
This study determined the role of social support, hardiness, and acculturation as predictors of mental health among international Asian Indian students enrolled at two large public universities in Ohio. A sample of 185 students completed a 75-item online instrument assessing their social support levels, acculturation, hardiness, and their mental health. Regression analyses were conducted to test for variance in mental health attributable to each of the three independent variables. The final regression model revealed that the belonging aspect of social support, acculturation and prejudice of acculturation scale, and commitment and control of hardiness were all predictive of mental health (R2 = 0.523). Recommendations have been offered to develop interventions that will help strengthen the social support, hardiness, and acculturation of international students and help improve their mental health. Recommendations for development of future Web-based studies also are offered.
Muñoz, Manuel; Sanz, María; Pérez-Santos, Eloísa; Quiroga, María de Los Ángeles
2011-04-30
The social stigma of mental illness has received much attention in recent years and its effects on diverse variables such as psychiatric symptoms, social functioning, self-esteem, self-efficacy, quality of life, and social integration are well established. However, internalized stigma in people with severe and persistent mental illness has not received the same attention. The aim of the present work was to study the relationships between the principal variables involved in the functioning of internalized stigma (sociodemographic and clinical variables, social stigma, psychosocial functioning, recovery expectations, empowerment, and discrimination experiences) in a sample of people with severe and persistent mental illness (N=108). The main characteristics of the sample and the differences between groups with high and low internalized stigma were analyzed, a correlation analysis of the variables was performed, and a structural equation model, integrating variables of social, cognitive, and behavioral content, was proposed and tested. The results indicate the relationships among social stigma, discrimination experiences, recovery expectation, and internalized stigma and their role in the psychosocial and behavioral outcomes in schizophrenia spectrum disorders. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Mouzon, Dawne M; McLean, Jamila S
2017-02-01
The tripartite model of racism includes personally mediated racism, institutionalized racism, and the less-oft studied internalized racism. Internalized racism - or negative beliefs about one's racial group - results from cultural racism that is endemic in American society. In this project, we studied whether these negative stereotypes are associated with mental health among African-Americans and Caribbean Blacks. Using secondary data from the National Survey of American Life, we investigated the association between internalized racism and mental health (measured by depressive symptoms and serious psychological distress (SPD)) among these two groups. We also explored whether ethnicity/nativity and mastery moderate the association between internalized racism and mental health among African-Americans and Caribbean Blacks. Internalized racism was positively associated with depressive symptoms and SPD among all Black subgroups. However, internalized racism was a weaker predictor of SPD among foreign-born Caribbean Blacks than US-born Caribbean Blacks and US-born African-Americans. Additionally, higher mastery was protective against distress associated with internalized racism. Internalized racism is an important yet understudied determinant of mental health among Blacks. Future studies should take into account additional heterogeneity within the Black population (e.g. African-born individuals) and other potential protective mechanisms in addition to mastery (e.g. self-esteem and racial identity).
Assertive outreach handbook will aid mental health staff in maintaining client engagement.
Gregory, Nathan; Macpherson, Rob
The model of assertive outreach is one of the most internationally researched areas of community mental healthcare. An assertive outreach team at a mental health trust developed a handbook on the model, involving contributions from service users, carers, local clinicians and the voluntary sector. This article outlines the process of developing the handbook, summarises its content and user feedback.
Software forecasting as it is really done: A study of JPL software engineers
NASA Technical Reports Server (NTRS)
Griesel, Martha Ann; Hihn, Jairus M.; Bruno, Kristin J.; Fouser, Thomas J.; Tausworthe, Robert C.
1993-01-01
This paper presents a summary of the results to date of a Jet Propulsion Laboratory internally funded research task to study the costing process and parameters used by internally recognized software cost estimating experts. Protocol Analysis and Markov process modeling were used to capture software engineer's forecasting mental models. While there is significant variation between the mental models that were studied, it was nevertheless possible to identify a core set of cost forecasting activities, and it was also found that the mental models cluster around three forecasting techniques. Further partitioning of the mental models revealed clustering of activities, that is very suggestive of a forecasting lifecycle. The different forecasting methods identified were based on the use of multiple-decomposition steps or multiple forecasting steps. The multiple forecasting steps involved either forecasting software size or an additional effort forecast. Virtually no subject used risk reduction steps in combination. The results of the analysis include: the identification of a core set of well defined costing activities, a proposed software forecasting life cycle, and the identification of several basic software forecasting mental models. The paper concludes with a discussion of the implications of the results for current individual and institutional practices.
Picco, Louisa; Pang, Shirlene; Lau, Ying Wen; Jeyagurunathan, Anitha; Satghare, Pratika; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Lim, Susan; Poh, Chee Lien; Chong, Siow Ann; Subramaniam, Mythily
2016-12-30
This study aimed to: (i) determine the prevalence, socio-demographic and clinical correlates of internalized stigma and (ii) explore the association between internalized stigma and quality of life, general functioning, hope and self-esteem, among a multi-ethnic Asian population of patients with mental disorders. This cross-sectional, survey recruited adult patients (n=280) who were seeking treatment at outpatient and affiliated clinics of the only tertiary psychiatric hospital in Singapore. Internalized stigma was measured using the Internalized Stigma of Mental Illness scale. 43.6% experienced moderate to high internalized stigma. After making adjustments in multiple logistic regression analysis, results revealed there were no significant socio-demographic or clinical correlates relating to internalized stigma. Individual logistic regression models found a negative relationship between quality of life, self-esteem, general functioning and internalized stigma whereby lower scores were associated with higher internalized stigma. In the final regression model, which included all psychosocial variables together, self-esteem was the only variable significantly and negatively associated with internalized stigma. The results of this study contribute to our understanding of the role internalized stigma plays in patients with mental illness, and the impact it can have on psychosocial aspects of their lives. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Use of Online Forums for Perinatal Mental Illness, Stigma, and Disclosure: An Exploratory Model.
Moore, Donna; Drey, Nicholas; Ayers, Susan
2017-02-20
Perinatal mental illness is a global health concern; however, many women with the illness do not get the treatment they need to recover. Interventions that reduce the stigma around perinatal mental illness have the potential to enable women to disclose their symptoms to health care providers and consequently access treatment. There are many online forums for perinatal mental illness and thousands of women use them. Preliminary research suggests that online forums may promote help-seeking behavior, potentially because they have a role in challenging stigma. This study draws from these findings and theoretical concepts to present a model of forum use, stigma, and disclosure. This study tested a model that measured the mediating role of stigma between online forum use and disclosure of affective symptoms to health care providers. A Web-based survey of 200 women who were pregnant or had a child younger than 5 years and considered themselves to be experiencing psychological distress was conducted. Women were recruited through social media and questions measured forum usage, perinatal mental illness stigma, disclosure to health care providers, depression and anxiety symptoms, barriers to disclosure, and demographic information. There was a significant positive indirect effect of length of forum use on disclosure of symptoms through internal stigma, b=0.40, bias-corrected and accelerated (BCa) 95% CI 0.13-0.85. Long-term forum users reported higher levels of internal stigma, and higher internal stigma was associated with disclosure of symptoms to health care providers when controlling for symptoms of depression and anxiety. Internal stigma mediates the relationship between length of forum use and disclosure to health care providers. Findings suggest that forums have the potential to enable women to recognize and reveal their internal stigma, which may in turn lead to greater disclosure of symptoms to health care providers. Clinicians could refer clients to trustworthy and moderated online forums that facilitate expression of perinatal mental illness stigma and promote disclosure to health care providers. ©Donna Moore, Nicholas Drey, Susan Ayers. Originally published in JMIR Mental Health (http://mental.jmir.org), 20.02.2017.
Pérez-Garín, Daniel; Molero, Fernando; Bos, Arjan E R
2017-04-01
The goal of this study is to test a model in which personal discrimination predicts internalized stigma, while group discrimination predicts a greater willingness to engage in collective action. Internalized stigma and collective action, in turn, are associated to positive and negative affect. A cross-sectional study with 213 people with mental illness was conducted. The model was tested using path analysis. Although the data supported the model, its fit was not sufficiently good. A respecified model, in which a direct path from collective action to internalized stigma was added, showed a good fit. Personal and group discrimination appear to impact subjective well-being through two different paths: the internalization of stigma and collective action intentions, respectively. These two paths, however, are not completely independent, as collective action predicts a lower internalization of stigma. Thus, collective action appears as an important tool to reduce internalized stigma and improve subjective well-being. Future interventions to reduce the impact of stigma should fight the internalization of stigma and promote collective action are suggested.
Gardner, Aimee K; Scott, Daniel J; AbdelFattah, Kareem R
2017-05-01
Team mental models represent the shared understanding of team members within their relevant environment. Thus, team mental models should have a substantial impact on a team's ability to engage in purposeful and coordinated action. We sought to examine the impact of shared team mental models on team performance and to investigate if team mental models increase over time as teams continue to work together. New surgery interns were assigned randomly to 1 of 10 teams. Each team participated in one unique simulation every day for 5 days, each followed by video-based debriefing with a facilitator. Participants also completed independently a concept similarity tool validated previously in nonmedical team literature to assess team mental models. All performances were video recorded and evaluated with a scenario-specific team performance tool by a single, blinded junior surgeon under an institutional review board-approved protocol. Changes in performance and team mental models over time were assessed with paired samples t tests. Regression analysis was used to examine the extent to which team mental models predicted team performance. Thirty interns (age 27; 77% men) participated in the training program. Percentage of items achieved (x¯ ± SD) on the performance evaluation was 39 ± 20, 51 ± 14, 22 ± 17, 63 ± 14, and 77 ± 25 for Days 1-5, respectively. Team mental models were 30 ± 5, 28 ± 6, 27 ± 8, 26 ± 7, and 25 ± 6 for Days 1-5 respectively, such that larger values corresponded to greater differences in team mental models. Paired sample t tests indicated that both average performance and team mental models similarity improved from the first to last day (P < .01, P < .05, respectively). Additionally, regression analyses indicated that team mental models predicted team performance on Days 2-5 (all P < .05) but not on the first day of simulations. These results demonstrate that greater sharing of team mental models among the teams leads to better team performance. Additionally, the increase in team mental models over time suggests that engaging in team-based simulation may catalyze the process by which surgery teams are able to develop shared knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.
Gearing, Robin E; MacKenzie, Michael J; Schwalbe, Craig S; Brewer, Kathryne B; Ibrahim, Rawan W
2013-02-01
This study aimed to establish the prevalence rates of mental health and behavioral problems of Arab youths residing in Jordanian care centers due to family disintegration, maltreatment, or abandonment and to examine how functioning varies by child characteristics and placement history. Child Behavior Checklist and case history data were collected for 70 youths across four Jordanian care centers. Approximately 53% of the adolescents were identified as experiencing mental health problems, and 43% and 46% had high internalizing and externalizing scores, respectively. Ordinary least-squares regression models examining mental health functioning showed that male gender, care entry because of maltreatment, time in care, and transfers were the most significant predictors of problems. Paralleling international research, this study found high levels of mental health needs among institutionalized youths. The impact of transfers on functioning is particularly worrisome, given the standard practice of transferring youths to another facility when they reach age 12. Improving the institutional care model by requiring fewer transfers and offering family-based community alternatives may ameliorate risks of developing mental and behavioral problems.
Villotti, Patrizia; Corbière, Marc; Dewa, Carolyn S; Fraccaroli, Franco; Sultan-Taïeb, Hélène; Zaniboni, Sara; Lecomte, Tania
2017-09-12
Compared to groups with other disabilities, people with a severe mental illness face the greatest stigma and barriers to employment opportunities. This study contributes to the understanding of the relationship between workplace social support and work productivity in people with severe mental illness working in Social Enterprises by taking into account the mediating role of self-stigma and job tenure self-efficacy. A total of 170 individuals with a severe mental disorder employed in a Social Enterprise filled out questionnaires assessing personal and work-related variables at Phase-1 (baseline) and Phase-2 (6-month follow-up). Process modeling was used to test for serial mediation. In the Social Enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems. When testing serial multiple mediations, the specific indirect effect of high workplace social support on work productivity through both low internalized stigma and high job tenure self-efficacy was significant with a point estimate of 1.01 (95% CI = 0.42, 2.28). Continued work in this area can provide guidance for organizations in the open labor market addressing the challenges posed by the work integration of people with severe mental illness. Implications for Rehabilitation: Work integration of people with severe mental disorders is difficult because of limited access to supportive and nondiscriminatory workplaces. Social enterprise represents an effective model for supporting people with severe mental disorders to integrate the labor market. In the social enterprise workplace, social support yields better perceptions of work productivity through lower levels of internalized stigma and higher confidence in facing job-related problems.
Bauer, Amy M; Fielke, Ken; Brayley, John; Araya, Mesfin; Alem, Atalay; Frankel, Bernard L; Fricchione, Gregory L
2010-01-01
Consultation-liaison (C-L) psychiatry, informed by principles of psychosomatic medicine, is well-positioned to address the global impact of mental disorders through primary care C-L models. The authors review the international burden of mental disorders, highlighting medical comorbidity, undertreatment, and the rationale for enhancing primary-care management. C-L psychiatry fosters the skills required for global mental health work. The authors describe successful C-L models developed in a low-income country (Ethiopia) and an under-resourced region of a high-income country (Australia). C-L psychiatrists have the potential to marshal their unique skill-set to reduce the global burden of mental disorders.
Christoph, Mary J; Jarrett, Elizabeth S; Gower, Amy L; Borowsky, Iris W
To measure how weight status and weight perception relate to mental distress and psychosocial protective factors in adolescents. Adolescents in 8th, 9th, and 11th grade participating in the 2013 Minnesota Student Survey (N = 122,180) were classified on the basis of weight perception (overweight or not overweight) and weight status (not overweight, overweight, obese). Bivariate tests were used to assess the relationship of weight status and weight perception with internal mental distress, and generalized linear models were used to measure the association between weight status and weight perception with psychosocial protective factors including parent, school, and friend connectedness, social competency, and positive identity. Logistic regressions measured the relationship between psychosocial protective factors and internal mental distress. Prevalence of internal mental distress ranged from 14.5% for overweight boys who perceived themselves as not overweight to 55.0% for girls who were not overweight but self-perceived as overweight. Across all weight-status categories, adolescents who perceived themselves as overweight, compared to those who did not, had higher internal mental distress and lower mean levels of psychosocial protective factors. All psychosocial protective factors were related to lower odds of internal mental distress, with significant small differences by weight status and weight perception. Weight status and weight perception affected both mental distress and psychosocial protective factors. Those who perceived themselves as overweight, regardless of weight status, had the highest prevalence of mental distress and the lowest levels of psychosocial protective factors. Health care providers should consider screening for weight perception to provide a tailored approach to adolescent care. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Salvador-Carulla, L; Hernández-Peña, P
2011-03-01
This paper discusses an integrated approach to mental health studies on Financing of Illness (FoI) and health accounting, Cost of Illness (CoI) and Burden of Disease (BoD). In order to expand the mental health policies, the following are suggested: (a) an international consensus on the standard scope, methods to collect and to analyse mental health data, as well as to report comparative information; (b) mathematical models are also to be validated and tested in an integrated approach, (c) a better knowledge transfer between clinicians and knowledge engineers, and between researchers and policy makers to translate economic analysis into practice and health planning.
ERIC Educational Resources Information Center
Bengtson, Barbara J.
2013-01-01
Understanding the linear relationship of numbers is essential for doing practical and abstract mathematics throughout education and everyday life. There is evidence that number line activities increase learners' number sense, improving the linearity of mental number line representations (Siegler & Ramani, 2009). Mental representations of…
ERIC Educational Resources Information Center
Fornes, Sandra; Rosenberg, Howard; Rocco, Tonette S.; Gallagher, Jo
2006-01-01
This literature review discusses the factors for successful job retention of adult workers with mental retardation (MR) including external factors related to work environments and internal issues of the individual worker. Through the synthesis of the literature, a performance improvement model for supported employment (SE) is discussed based on…
Integrative Mental Health (IMH): paradigm, research, and clinical practice.
Lake, James; Helgason, Chanel; Sarris, Jerome
2012-01-01
This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care. Copyright © 2012 Elsevier Inc. All rights reserved.
Is there a risk profile for the vulnerable junior doctor?
Byrne, D; Buttrey, S; Carberry, C; Lydon, S; O'Connor, P
2016-08-01
Mental ill health is prevalent among doctors, especially those in the early stages of postgraduate training. However, a paucity of research has examined factors predictive of psychological distress in this population. To report the findings from a multi-centre survey of mental health among junior doctors in Ireland, and assess the extent to which moderator variables (e.g., age, academic performance, nationality, etc.) alter the levels of psychological distress caused by internship. An online, anonymous, questionnaire was distributed to all interns in the Republic of Ireland in January 2012. A total of 270 interns responded to the survey (45.0 % response rate), with 48.5 % of the respondents having a score indicative of psychological distress. A regression model found that nationality, academic performance, intern training network, rating of work stressors, home stressors, and work-life balance were associated with differing levels of mental health as measured by the General Health Questionnaire-12. There is a need to consider moderator variables when examining mental health in healthcare populations to avoid drawing overly simplistic conclusions. Interns in Ireland reported particularly high levels of psychological distress compared to other studies of mental health among healthcare populations.
Murray, L K; Jordans, M J D
2016-07-12
Global mental health is a growing field intricately connected to broader health, violence and economic issues. Despite the high prevalence and cost of mental health disorders, an estimated 75 % of those with need in lower resource settings do not receive intervention. Most studies to date have examined the effectiveness of single-disorder mental health treatments - an approach that may be a significant challenge to scale-up and sustainability in lower resource settings. This paper presents a brief overview of the scientific progress in global mental health, and suggests consideration of an internal stepped care delivery approach. An internal stepped care model is one idea of a delivery system, utilizing a common elements approach, where the same provider could navigate between different elements based on severity and type of problems of the client. It is distinct from traditional stepped care models in that clients remain with the same provider, rather than relying on referral systems. An internal stepped care delivery system based on a simplified common elements approach could be more efficient, scalable, sustainable, and reduce the loss of clients to referrals in lower resource settings.
Validation of the Malayalam version of the Internalized Stigma of Mental Illness (ISMI) scale.
James, Tintu; Kutty, V Raman; Boyd, Jennifer; Brzoska, Patrick
2016-04-01
Little is known about internalized stigma of mental illness in India. A reason for this could be the lack of valid assessment instruments adapted for the diverse cultures and languages of the country. One of the most widely used and accepted questionnaires to assess internalized stigma is the 29-item Internalized Stigma of Mental Illness (ISMI) scale. The aim of the present study was to translate and adapt the ISMI to the Malayalam-speaking population of Kerala, India and to assess its content and factorial validity. The content validity of the Malayalam-language ISMI was studied through interviews with 7 experts on stigma in India. Factorial validity was examined by means of a confirmatory factor analysis (CFA) based on a cross-sectional survey among 290 patients with mental illness attending follow-up outpatient and primary care clinics in Kerala, India. The expert panel concluded that the items of the translated questionnaire adequately represent internalized stigma in the Malayalam-speaking population of Kerala. The theorized factor structure of the ISMI consisting of five factors showed a suboptimal model fit (WRMR=0.940; TLI=0.971, CFI=0.948; RMSEA=0.059) which improved considerably after removal of the stigma resistance factor and three items with poor factor loadings (WRMR=0.819; TLI=0.982, CFI=0.966; RMSEA=0.051). Although our study identifies some sources of model ill-fit, it shows that a reduced version of the Malayalam-language ISMI can be a valuable tool for the study of internalized stigma in this cultural setting. Copyright © 2016 Elsevier B.V. All rights reserved.
Bochicchio, Vincenzo; Amodeo, Anna Lisa; Esposito, Concetta; Valerio, Paolo; Maldonato, Nelson Mauro; Bacchini, Dario; Vitelli, Roberto
2018-01-01
Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation) mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma. PMID:29534023
Strandh, Mattias; Nilsson, Karina; Nordlund, Madelene; Hammarström, Anne
2015-11-20
Recent findings suggest that the mental health costs of unemployment are related to both short- and long-term mental health scars. The main policy tools for dealing with young people at risk of labor market exclusion are Active Labor Market Policy programs for youths (youth programs). There has been little research on the potential effects of participation in youth programs on mental health and even less on whether participation in such programs alleviates the long-term mental health scarring caused by unemployment. This study compares exposure to open youth unemployment and exposure to youth program participation between ages 18 and 21 in relation to adult internalized mental health immediately after the end of the exposure period at age 21 and two decades later at age 43. The study uses a five wave Swedish 27-year prospective cohort study consisting of all graduates from compulsory school in an industrial town in Sweden initiated in 1981. Of the original 1083 participants 94.3% of those alive were still participating at the 27-year follow up. Exposure to open unemployment and youth programs were measured between ages 18-21. Mental health, indicated through an ordinal level three item composite index of internalized mental health symptoms (IMHS), was measured pre-exposure at age 16 and post exposure at ages 21 and 42. Ordinal regressions of internalized mental health at ages 21 and 43 were performed using the Polytomous Universal Model (PLUM). Models were controlled for pre-exposure internalized mental health as well as other available confounders. Results show strong and significant relationships between exposure to open youth unemployment and IMHS at age 21 (OR = 2.48, CI = 1.57-3.60) as well as at age 43 (OR = 1.71, CI = 1.20-2.43). No such significant relationship is observed for exposure to youth programs at age 21 (OR = 0.95, CI = 0.72-1.26) or at age 43 (OR = 1.23, CI = 0.93-1.63). A considered and consistent active labor market policy directed at youths could potentially reduce the short- and long-term mental health costs of youth unemployment.
A Model of Mental State Transition Network
NASA Astrophysics Data System (ADS)
Xiang, Hua; Jiang, Peilin; Xiao, Shuang; Ren, Fuji; Kuroiwa, Shingo
Emotion is one of the most essential and basic attributes of human intelligence. Current AI (Artificial Intelligence) research is concentrating on physical components of emotion, rarely is it carried out from the view of psychology directly(1). Study on the model of artificial psychology is the first step in the development of human-computer interaction. As affective computing remains unpredictable, creating a reasonable mental model becomes the primary task for building a hybrid system. A pragmatic mental model is also the fundament of some key topics such as recognition and synthesis of emotions. In this paper a Mental State Transition Network Model(2) is proposed to detect human emotions. By a series of psychological experiments, we present a new way to predict coming human's emotions depending on the various current emotional states under various stimuli. Besides, people in different genders and characters are taken into consideration in our investigation. According to the psychological experiments data derived from 200 questionnaires, a Mental State Transition Network Model for describing the transitions in distribution among the emotions and relationships between internal mental situations and external are concluded. Further more the coefficients of the mental transition network model were achieved. Comparing seven relative evaluating experiments, an average precision rate of 0.843 is achieved using a set of samples for the proposed model.
Parent Influences on Early Childhood Internalizing Difficulties
ERIC Educational Resources Information Center
Bayer, Jordana, K.; Sanson, Ann, V.; Hemphill, Sheryl A.
2006-01-01
Children's internalizing problems are a concerning mental health issue, due to significant prevalence and continuity over time. This study tested a multivariate model predicting young children's internalizing behaviors from parenting practices, parents' anxiety-depression and family stressors. A community sample of 2 year old children (N=112) was…
Veldman, Karin; Bültmann, Ute; Stewart, Roy E.; Ormel, Johan; Verhulst, Frank C.; Reijneveld, Sijmen A.
2014-01-01
Background This study examines if mental health problems at age 11 and changes in mental health problems between age 11 and 16 predict educational attainment of adolescents at age 19, overall and stratified by gender. Methods Data from 1711 adolescents (76.8% from initial cohort) of the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9year follow-up, were used. Mental health problems (externalizing, internalizing and attention problems) were measured by the Youth Self Report and the Child Behavior Checklist at ages 11 and 16. Difference scores for mental health problems between age 11 and 16 were calculated. Educational attainment was assessed at age 19. Results Externalizing, internalizing and attention problems at age 11 were significantly associated with low educational attainment at age 19 (crude model). When adjusted for demographic variables and the other mental health problems, only the association for attention problems remained significant (odds ratio (OR), 95% confidence interval: 3.19, 2.11–4.83). Increasing externalizing problems between age 11 and 16 also predicted low educational attainment at age 19 (OR 3.12, 1.83–5.32). Among girls, increasing internalizing problems between age 11 and 16 predicted low educational attainment (OR 2.21, 1.25–3.94). For boys, no significant association was found for increasing internalizing problems and low educational attainment. For increasing attention problems between age 11 and 16 no significant association with low educational attainment was found. Conclusions Externalizing, internalizing and attention problems at age 11 and an increase of these problems during adolescence predicted low educational attainment at age 19. Early treatment of these mental health problems may improve educational attainment, and reduce socioeconomic health differences in adulthood. PMID:25047692
Modeling Common-Sense Decisions
NASA Astrophysics Data System (ADS)
Zak, Michail
This paper presents a methodology for efficient synthesis of dynamical model simulating a common-sense decision making process. The approach is based upon the extension of the physics' First Principles that includes behavior of living systems. The new architecture consists of motor dynamics simulating actual behavior of the object, and mental dynamics representing evolution of the corresponding knowledge-base and incorporating it in the form of information flows into the motor dynamics. The autonomy of the decision making process is achieved by a feedback from mental to motor dynamics. This feedback replaces unavailable external information by an internal knowledgebase stored in the mental model in the form of probability distributions.
The complex terrain of peer support in mental health: What does it all mean?
Murphy, Rebecca; Higgins, Agnes
2018-05-24
Emerging from cumulative socio-political movements forged by persons with self-experience of mental health difficulties, since the 1970s the practice of peer support has rapidly developed within mental health care. Now revered as a critical component to recovery oriented mental health service, peer support features prominently in international mental health policy and practice (Penney, 2018; Watts & Higgins, 2017; Cyr et al., 2016; Stamou, 2014; Bassett et al., 2010). As a consequence of this extensive growth, the field of peer support is flooded with various models including, but not limited to, individual and collective models that can be face-to-face or online, and positioned within mainstream mental health services, and/or peer-run organisations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
The Centre for International Mental Health Approach to Mental Health System Development
Minas, Harry
2012-01-01
Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to developmental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka. (harv rev psychiatry 2012;20:37–46.) PMID:22335181
Świtaj, Piotr; Grygiel, Paweł; Chrostek, Anna; Nowak, Izabela; Wciórka, Jacek; Anczewska, Marta
2017-09-01
To elucidate the mechanism through which internalized stigma reduces the quality of life (QoL) of people with mental illness by exploring the mediating roles of self-esteem and sense of coherence (SOC). A cross-sectional analysis of 229 patients diagnosed with schizophrenia or affective disorders was undertaken to test a sequential mediation model assuming that more severe internalized stigma is related to lower self-esteem, which is associated with weaker SOC, which in turn relates to worse QoL. The proposed model was supported by the data. A sequential indirect effect from internalized stigma to QoL via self-esteem and SOC turned out to be significant [beta = -0.06, SE = 0.02; 95% CI (-0.11, -0.03)]. Support was also found for simple mediation models with either self-esteem or SOC as single mediators between internalized stigma and QoL. Self-esteem and SOC are personal resources that should be considered as potential targets of interventions aiming to prevent the harmful consequences of internalized stigma for the QoL of people receiving psychiatric treatment.
Paraskevoulakou, Alexia; Vrettou, Kassiani; Pikouli, Katerina; Triantafillou, Evgenia; Lykou, Anastasia; Economou, Marina
2017-09-01
Since evaluation regarding the impact of mental illness related internalized stigma is scarce, there is a great need for psychometric instruments which could contribute to understanding its adverse effects among Greek patients with severe mental illness. The Brief Internalized Stigma of Mental Illness (ISMI) scale is one of the most widely used measures designed to assess the subjective experience of stigma related to mental illness. The present study aimed to investigate the psychometric properties of the Greek version of the Brief ISMI scale. In addition to presenting psychometric findings, we explored the relationship of the Greek version of the Brief ISMI subscales with indicators of self-esteem and quality of life. 272 outpatients (108 males, 164 females) meeting the DSM-IV TR criteria for severe mental disorder (schizophrenia, bipolar disorder, major depression) completed the Brief ISMI, the RSES and the WHOQOL-BREF scales. Patients reported age and educational level. A retest was conducted with 124 patients. The Chronbach's alpha coefficient was 0 0.83. The test-retest reliability coefficients varied from 0.81 to 0.91, indicating substantial agreement. The ICC was for the total score 0.83 and for the two factors, 0.69 and 0.77 respectively. Factor analysis provided strong evidence for a two factor model. Factors 1 and 2 were named respectively "how others view me" and "how I view myself". They were negatively correlated with both RSES and WHOQOL-BREF scales, as well as with educational level. Factor 2 was significantly associated with the type of diagnosis. The Greek version of the Brief ISMI scale can be used as a reliable and valid tool for assessing mental illness related internalized stigma among Greek patients with severe mental illness.
The Rights and Freedoms Gradient of Health: Evidence from a Cross-National Study
Bezo, Brent; Maggi, Stefania; Roberts, William L.
2012-01-01
This study examined the combined influences of national levels of socioeconomic status (SES), social capital, and rights and freedoms on population level physical and mental health outcomes. Indicators of mental health were suicide rates, alcohol consumption, and tobacco use. Indicators of physical health included life expectancy, infant mortality rates, and prevalence of HIV. Using pathway analysis on international data from a selected sample of European, North American, South American, and South Caucasus countries, similar models for mental health and physical health were developed. In the first model, the positive effects of SES and social capital on physical health were completely mediated via rights and freedoms. In the second model, the positive effect of SES on mental health was completely mediated, while the impact of social capital was partially mediated through rights and freedoms. We named the models, the “rights and freedoms gradient of health” in recognition of this latter construct’s crucial role in determining both physical and mental health. PMID:23162498
Hides, Leanne; Quinn, Catherine; Stoyanov, Stoyan; Cockshaw, Wendell; Mitchell, Tegan; Kavanagh, David J
2016-07-30
Internationally there is a growing interest in the mental wellbeing of young people. However, it is unclear whether mental wellbeing is best conceptualized as a general wellbeing factor or a multidimensional construct. This paper investigated whether mental wellbeing, measured by the Mental Health Continuum-Short Form (MHC-SF), is best represented by: (1) a single-factor general model; (2) a three-factor multidimensional model or (3) a combination of both (bifactor model). 2220 young Australians aged between 16 and 25 years completed an online survey including the MHC-SF and a range of other wellbeing and mental ill-health measures. Exploratory factor analysis supported a bifactor solution, comprised of a general wellbeing factor, and specific group factors of psychological, social and emotional wellbeing. Confirmatory factor analysis indicated that the bifactor model had a better fit than competing single and three-factor models. The MHC-SF total score was more strongly associated with other wellbeing and mental ill-health measures than the social, emotional or psychological subscale scores. Findings indicate that the mental wellbeing of young people is best conceptualized as an overarching latent construct (general wellbeing) to which emotional, social and psychological domains contribute. The MHC-SF total score is a valid and reliable measure of this general wellbeing factor. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Rendina, H Jonathon; Gamarel, Kristi E; Pachankis, John E; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T
2017-04-01
Minority stress theory represents the most plausible conceptual framework for explaining health disparities for gay and bisexual men (GBM). However, little focus has been given to including the unique stressors experienced by HIV-positive GBM. We explored the role of HIV-related stress within a minority stress model of mental health and condomless anal sex. Longitudinal data were collected on a diverse convenience sample of 138 highly sexually active, HIV-positive GBM in NYC regarding sexual minority (internalized homonegativity and gay-related rejection sensitivity) and HIV-related stressors (internalized HIV stigma and HIV-related rejection sensitivity), emotion dysregulation, mental health (symptoms of depression, anxiety, sexual compulsivity, and hypersexuality), and sexual behavior (condomless anal sex with all male partners and with serodiscordant male partners). Across both sexual minority and HIV-related stressors, internalized stigma was significantly associated with mental health and sexual behavior outcomes while rejection sensitivity was not. Moreover, path analyses revealed that emotion dysregulation mediated the influence of both forms of internalized stigma on symptoms of depression/anxiety and sexual compulsivity/hypersexuality as well as serodiscordant condomless anal sex. We identified two targets of behavioral interventions that may lead to improvements in mental health and reductions in sexual transmission risk behaviors-maladaptive cognitions underlying negative self-schemas and difficulties with emotion regulation. Techniques for cognitive restructuring and emotion regulation may be particularly useful in the development of interventions that are sensitive to the needs of this population while also highlighting the important role that structural interventions can have in preventing these disparities for future generations.
Rendina, H. Jonathon; Gamarel, Kristi E.; Pachankis, John E.; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T.
2016-01-01
Background Minority stress theory represents the most plausible conceptual framework for explaining health disparities for gay and bisexual men (GBM). However, little focus has been given to including the unique stressors experienced by HIV-positive GBM. Purpose We explored the role of HIV-related stress within a minority stress model of mental health and condomless anal sex. Methods Longitudinal data were collected on a diverse convenience sample of 138 highly sexually active, HIV-positive GBM in NYC regarding sexual minority (internalized homonegativity, gay-related rejection sensitivity) and HIV-related stressors (internalized HIV stigma, HIV-related rejection sensitivity), emotion dysregulation, mental health (symptoms of depression, anxiety, sexual compulsivity, and hypersexuality), and sexual behavior (condomless anal sex with all male partners and with serodiscordant male partners). Results Across both sexual minority and HIV-related stressors, internalized stigma was significantly associated with mental health and sexual behavior outcomes while rejection sensitivity was not. Moreover, path analyses revealed that emotion dysregulation mediated the influence of both forms of internalized stigma on symptoms of depression/anxiety and sexual compulsivity/hypersexuality as well as serodiscordant condomless anal sex. Conclusions We identified two targets of behavioral interventions that may lead to improvements in mental health and reductions in sexual transmission risk behaviors—maladaptive cognitions underlying negative self-schemas and difficulties with emotion regulation. Techniques for cognitive restructuring and emotion regulation may be particularly useful in the development of interventions that are sensitive to the needs of this population while also highlighting the important role that structural interventions can have in preventing these disparities for future generations. PMID:27502073
Kessler, Rodger
2012-01-01
Most primary care patients with mental health issues are identified or treated in primary care rather than the specialty mental health system. Primary care physicians report that their patients do not have access to needed mental health care. When referrals are made to the specialty behavioral or mental health care system, rates of patients who initiate treatment are low. Collaborative care models, with mental health clinicians as part of the primary care medical staff, have been suggested as an alternative. The aim of this study is to examine rates of treatment startup in 2 collaborative care settings: a rural family medicine office and a suburban internal medicine office. In both practices referrals for mental health services are made within the practice. Referral data were drawn from 2 convenience samples of patients referred by primary care physicians for collaborative mental health treatment at Fletcher Allen Health Care in Vermont. The first sample consisted of 93 consecutively scheduled referrals in a family medicine office (sample A) between January 2006 and December 2007. The second sample consisted of 215 consecutive scheduled referrals at an internal medicine office (sample B) between January 2009 and December 2009. Referral data identified age, sex, and presenting mental health/medical problem. In sample A, 95.5% of those patients scheduling appointments began behavioral health treatment; in sample B this percentage was 82%. In sample B, 69% of all patients initially referred for mental health care both scheduled and initiated treatment. When referred to a mental health clinician who provides on-site access as part of a primary care mental health collaborative care model, a high percentage of patients referred scheduled care. Furthermore, of those who scheduled care, a high percentage of patients attend the scheduled appointment. Findings persist despite differences in practice type, populations, locations, and time frames of data collection. That the findings persist across the different offices suggests that this model of care may contain elements that improve the longstanding problem of poor treatment initiation rates when primary care physicians refer patients for outpatient behavioral health services.
Gloppen, Kari; McMorris, Barbara; Gower, Amy; Eisenberg, Marla
2017-08-17
Bullying involvement as a victim or perpetrator is associated with depression and suicidality, and American Indian (AI) youth experience a disproportionately high rate of these mental health issues. This study assessed whether AI young people involved in bullying were more likely to experience negative mental health problems than AI youth who were not involved in bullying, and identified protective factors that might support this particularly vulnerable population. Data come from 1,409 8th, 9th, and 11th Grade AI students who completed the 2013 Minnesota Student Survey. Logistic regression models estimated associations between bullying involvement and internalizing symptoms and suicidality. Selected protective factors (internal assets, empowerment, positive student-teacher relationships, and feeling safe at school) were also examined as independent variables. All forms of bullying perpetration and victimization were associated with increased risk for mental health problems (odds ratio [OR]: 1.57-2.87). AI youth who reported higher levels of protective factors were less likely to report internalizing symptoms and suicidality even in the presence of bullying involvement. For example, AI youth who reported high levels of internal assets had half the odds of reporting internalizing symptoms compared with those with low levels of internal assets (OR = 0.53, confidence interval [CI] 0.38, 0.74). Findings suggest that, similar to a general sample of students, bullying-involved AI students are significantly more likely to experience mental health problems. Promoting school as a safe place and incorporating culturally relevant programming to promote internal assets such as positive identity, social competence, and empowerment among AI students could help reduce the negative effects of bullying involvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Howell, Alison; Mills, China; Rushton, Simon
2017-07-01
Mental health is increasingly finding a place on global health and international development agendas. Advocates for Global Mental Health (GMH), and international organizations such as the World Health Organization (WHO) and the World Bank, argue that treatments available in high-income countries should also be made available in low- and middle-income countries. Such arguments are often made by comparing mental health to infectious diseases, including the relative disease and economic burdens they impose, and pointing to the applicability of the right to access treatment for mental health, not only infectious diseases. HIV/AIDS advocacy in particular has been held up by GMH advocates as offering an appropriate strategy for generating global commitment. There is a need to assess how health issues are framed not only in relation to social goods outside of health (such as human rights, security or development), but also in relation to other health or disease models, and how health policy and practice is shaped as a result. The article debates the merits and consequences of likening mental health to HIV/AIDS, and identifies four major problems with the model for GMH advocacy being developed through these analogies: 1. An inappropriately universalizing global approach to context-specific problems; 2. A conception of human rights that focuses on the right to access treatment at the expense of the right to refuse it; 3. A tendency to treat poverty as a psychiatric issue, rather than recognizing that mental distress can be the result of poverty and other forms of inequality; 4. The prioritization of destigmatization of disease over social justice models. There are significant problems with the wholesale adoption of an (often simplified) version of HIV/AIDS advocacy as a model for GMH. Yet critical engagement with the important and nuanced differences between HIV/AIDS and mental health may nevertheless point to some possibilities for productive engagement and cross-fertilisation between advocates, activists and scholars in both fields.
Graham, John; Zheng, Liya; Gonzalez, Cleotilde
2006-06-01
We developed a technique to observe and characterize a novice real-time-strategy (RTS) player's mental model as it shifts with experience. We then tested this technique using an off-the-shelf RTS game, EA Games Generals. Norman defined mental models as, "an internal representation of a target system that provides predictive and explanatory power to the operator." In the case of RTS games, the operator is the player and the target system is expressed by the relationships within the game. We studied five novice participants in laboratory-controlled conditions playing a RTS game. They played Command and Conquer Generals for 2 h per day over the course of 5 days. A mental model analysis was generated using player dissimilarity-ratings of the game's artificial intelligence (AI) agents analyzed using multidimensional scaling (MDS) statistical methods. We hypothesized that novices would begin with an impoverished model based on the visible physical characteristics of the game system. As they gained experience and insight, their mental models would shift and accommodate the functional characteristics of the AI agents. We found that all five of the novice participants began with the predicted physical-based mental model. However, while their models did qualitatively shift with experience, they did not necessarily change to the predicted functional-based model. This research presents an opportunity for the design of games that are guided by shifts in a player's mental model as opposed to the typical progression through successive performance levels.
Saragih Turnip, Sherly; Sörbom, Dag; Hauff, Edvard
2016-01-01
Positive mental health, rather than just the absence of mental illness, is rarely investigated among the internally displaced persons (IDPs) affected by violent conflict in low-income countries. The purpose of this study was to investigate a model that could explain the interrelationship between factors contributing to positive mental health in displaced populations. In a longitudinal study we examine poverty, exposure to traumatic events and the change of material well-being after one year. We collected data in two consecutive years (2005 and 2006) from a community-based sample of IDPs in Ambon, Indonesia, through face-to-face structured interviews with consenting adults. Participants of this study were IDPs lived in Ambon during the violent conflict period. We interviewed 471 IDPs in the first year and reinterviewed 399 (85%) of the same subjects in the second year. The IDPs possessed good sense of coherence and subjective well-being. Our final model, which was generated by the use of structural equation modeling, fits the data well (χ(2) = 52.51, df = 45, p = .21, CFI = .99, RMSEA = .019). Exposure to violent conflict had a negative impact on IDPs' mental health initially and better economic conditions improved it (r = -.30 and .29 respectively). Mental health status one year previously was a strong predictor of future mental health, followed by individual economic growth in the past year (r = .43 and .29 respectively). On a group level the IDPs were resilient and adaptive to survive in adverse living conditions after devastating violent conflict, and the economic improvement contributed to it.
Narcissistic Personality Disorder and the Structure of Common Mental Disorders.
Eaton, Nicholas R; Rodriguez-Seijas, Craig; Krueger, Robert F; Campbell, W Keith; Grant, Bridget F; Hasin, Deborah S
2017-08-01
Narcissistic personality disorder (NPD) shows high rates of comorbidity with mood, anxiety, substance use, and other personality disorders. Previous bivariate comorbidity investigations have left NPD multivariate comorbidity patterns poorly understood. Structural psychopathology research suggests that two transdiagnostic factors, internalizing (with distress and fear subfactors) and externalizing, account for comorbidity among common mental disorders. NPD has rarely been evaluated within this framework, with studies producing equivocal results. We investigated how NPD related to other mental disorders in the internalizing-externalizing model using diagnoses from a nationally representative sample (N = 34,653). NPD was best conceptualized as a distress disorder. NPD variance accounted for by transdiagnostic factors was modest, suggesting its variance is largely unique in the context of other common mental disorders. Results clarify NPD multivariate comorbidity, suggest avenues for classification and clinical endeavors, and highlight the need to understand vulnerable and grandiose narcissism subtypes' comorbidity patterns and structural relations.
Familial risk and sibling mentalization: Links with preschoolers' internalizing problems.
Rodrigues, Michelle; Binnoon-Erez, Noam; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M
2017-09-01
The current study explored whether older sibling mentalization moderated the relationship between familial risk for internalizing symptoms and the development of future internalizing problems in the younger siblings, referred to as target children. Data were collected on 397 older siblings at Time 1 (T1) when target children were newborn and their older siblings were on average 2.61 years old (SD = .75). Target children were on average 1.60 years old at Time 2 (T2). Internalizing problems were assessed via mother and partner reports. Familial risk was operationalized as the average of all older siblings' level of internalizing problems. Older sibling mentalization, indexed by internal state talk and reasoning, was observed and coded during a sibling pretend-play interaction at T2. Results revealed a significant interaction between familial risk of internalizing problems and older siblings' mentalizing abilities, showing that familial risk was related to target children's internalizing problems in the absence of sibling mentalization. Familial risk was not associated with target children's internalizing problems when siblings demonstrated mentalizing abilities. Findings support the need to consider sibling mentalization as a protective factor for children's internalizing problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Anticipation by multi-modal association through an artificial mental imagery process
NASA Astrophysics Data System (ADS)
Gaona, Wilmer; Escobar, Esaú; Hermosillo, Jorge; Lara, Bruno
2015-01-01
Mental imagery has become a central issue in research laboratories seeking to emulate basic cognitive abilities in artificial agents. In this work, we propose a computational model to produce an anticipatory behaviour by means of a multi-modal off-line hebbian association. Unlike the current state of the art, we propose to apply hebbian learning during an internal sensorimotor simulation, emulating a process of mental imagery. We associate visual and tactile stimuli re-enacted by a long-term predictive simulation chain motivated by covert actions. As a result, we obtain a neural network which provides a robot with a mechanism to produce a visually conditioned obstacle avoidance behaviour. We developed our system in a physical Pioneer 3-DX robot and realised two experiments. In the first experiment we test our model on one individual navigating in two different mazes. In the second experiment we assess the robustness of the model by testing in a single environment five individuals trained under different conditions. We believe that our work offers an underpinning mechanism in cognitive robotics for the study of motor control strategies based on internal simulations. These strategies can be seen analogous to the mental imagery process known in humans, opening thus interesting pathways to the construction of upper-level grounded cognitive abilities.
Disorders without borders: current and future directions in the meta-structure of mental disorders.
Carragher, Natacha; Krueger, Robert F; Eaton, Nicholas R; Slade, Tim
2015-03-01
Classification is the cornerstone of clinical diagnostic practice and research. However, the extant psychiatric classification systems are not well supported by research evidence. In particular, extensive comorbidity among putatively distinct disorders flags an urgent need for fundamental changes in how we conceptualize psychopathology. Over the past decade, research has coalesced on an empirically based model that suggests many common mental disorders are structured according to two correlated latent dimensions: internalizing and externalizing. We review and discuss the development of a dimensional-spectrum model which organizes mental disorders in an empirically based manner. We also touch upon changes in the DSM-5 and put forward recommendations for future research endeavors. Our review highlights substantial empirical support for the empirically based internalizing-externalizing model of psychopathology, which provides a parsimonious means of addressing comorbidity. As future research goals, we suggest that the field would benefit from: expanding the meta-structure of psychopathology to include additional disorders, development of empirically based thresholds, inclusion of a developmental perspective, and intertwining genomic and neuroscience dimensions with the empirical structure of psychopathology.
Self-Stigma in People With Mental Illness
Watson, Amy C.; Corrigan, Patrick; Larson, Jonathon E.; Sells, Molly
2007-01-01
Persons with mental illnesses such as schizophrenia may internalize mental illness stigma and experience diminished self-esteem and self-efficacy. In this article, we describe a model of self-stigma and examine a hierarchy of mediational processes within the model. Seventy-one individuals with serious mental illness were recruited from a community support program at an outpatient psychiatry department of a community hospital. All participants completed the Self-Stigma of Mental Illness Scale along with measures of group identification (GI), perceived legitimacy (PL), self-esteem, and self-efficacy. Models examining the steps involved in self-stigma process were tested. Specifically, after conducting preliminary bivariate analyses, we examine stereotype agreement as a mediator of GI and PL on stigma self-concurrence (SSC); SSC as a mediator of GI and PL on self-efficacy; and SSC as a mediator of GI and PL on self-esteem. Findings provide partial support for the proposed mediational processes and point to GI, PL, and stereotype agreement as areas to be considered for intervention. PMID:17255118
Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care
Lake, James; Turner, Mason Spain
2017-01-01
Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally. This article reviews challenges facing mental health care and proposes an agenda for developing a collaborative care model in primary care settings that incorporates conventional biomedical therapies and complementary and alternative medicine approaches. By moving beyond treatment delivery via telephone and secure video and providing earlier interventions through primary care clinics, KP is shifting the paradigm of mental health care to a collaborative care model focusing on prevention. Recommendations are to expand current practices to include integrative treatment strategies incorporating evidence-based biomedical and complementary and alternative medicine modalities that can be provided to patients using a collaborative care model. Recommendations also are made for an internal research program aimed at investigating the efficacy and cost-effectiveness of promising complementary and alternative medicine and integrative treatments addressing the complex needs of patients with severe psychiatric disorders, many of whom respond poorly to treatments available in KP mental health clinics. PMID:28898197
Amone-P'Olak, Kennedy; Ormel, Johan; Huisman, Martijn; Verhulst, Frank C; Oldehinkel, Albertine J; Burger, Huibert
2009-10-01
Life stressors and family socioeconomic position have often been associated with mental health status. The aim of the present study is to contribute to the understanding of the pathways from low socioeconomic position and life stressors to mental problems. In a cross-sectional analysis using data from a longitudinal study of early adolescents (N = 2,149, 51% girls; mean age 13.6 years, SD 0.53, range 12-15), we assessed the extent of mediation of the association between family socioeconomic position and mental health problems by different types of life stressors in multiple regression models. Stressors were rated as environment related or person related. Information on socioeconomic position was obtained directly from parents, and internalizing and externalizing problem behaviors were assessed by reports from multiple informants (parents, self, and teachers). Low socioeconomic position was associated with more mental health problems and more life stressors. Both environment-related and person-related stressors predicted mental health problems independently of socioeconomic position. The associations between socioeconomic position and all mental health outcomes were partly mediated by environment-related life stressors. Mediation by environment-related and person-related stressors as assessed by linear regression amounted to 56% (95% confidence interval [CI] 35%-78%) and 7% (95% CI -25% to 38%) for internalizing problems and 13% (95% CI 7%-19%) and 5% (95% CI -2% to 13%) for externalizing problems, respectively. Environment-related, but not person-related, stressors partly mediated the association between socio economic position and adolescent mental problems. The extent of mediation was larger for internalizing than for externalizing problems. Because the effect sizes of the associations were relatively small, targeted interventions to prevent impaired mental health may have only modest benefits to adolescents from low socioeconomic background.
Consumer experience of formal crisis-response services and preferred methods of crisis intervention.
Boscarato, Kara; Lee, Stuart; Kroschel, Jon; Hollander, Yitzchak; Brennan, Alice; Warren, Narelle
2014-08-01
The manner in which people with mental illness are supported in a crisis is crucial to their recovery. The current study explored mental health consumers' experiences with formal crisis services (i.e. police and crisis assessment and treatment (CAT) teams), preferred crisis supports, and opinions of four collaborative interagency response models. Eleven consumers completed one-on-one, semistructured interviews. The results revealed that the perceived quality of previous formal crisis interventions varied greatly. Most participants preferred family members or friends to intervene. However, where a formal response was required, general practitioners and mental health case managers were preferred; no participant wanted a police response, and only one indicated a preference for CAT team assistance. Most participants welcomed collaborative crisis interventions. Of four collaborative interagency response models currently being trialled internationally, participants most strongly supported the Ride-Along Model, which enables a police officer and a mental health clinician to jointly respond to distressed consumers in the community. The findings highlight the potential for an interagency response model to deliver a crisis response aligned with consumers' preferences. © 2014 Australian College of Mental Health Nurses Inc.
Van Beusekom, Gabriël; Bos, Henny MW; Kuyper, Lisette; Overbeek, Geertjan; Sandfort, Theo GM
2016-01-01
We assessed among a sample of 724 Dutch lesbian, gay and bisexual-identified adults (Mage = 31.42) whether experiences with homophobic stigmatization and internalized homophobia simultaneously mediated the relation of gender nonconformity with mental health. Results indicated that homophobic stigmatization and internalized homophobia partially mediated the relation between gender nonconformity and mental health. Gender nonconformity was related to more mental health problems via increased experiences with homophobic stigmatization and to less mental health problems because of reduced levels of internalized homophobia. However, the mediated relation of gender nonconformity with mental health via homophobic stigmatization was only significant for men. PMID:27114216
Mellins, Claude A; Brackis-Cott, Elizabeth; Dolezal, Curtis; Leu, Cheng Shiun; Valentin, Cidna; Meyer-Bahlburg, Heino F L
2008-01-01
To examine the effect of maternal HIV infection, as well as other individual, family, and contextual factors on the mental health of inner-city, ethnic minority early adolescents. Participants included 220 HIV-negative early adolescents (10-14 years) and their mothers, half of whom were HIV-infected. Individual interviews were conducted regarding youth depression, anxiety, externalizing and internalizing behaviour problems, as well as a range of correlates of youth mental health guided by a modified version of Social Action Theory, a theoretical model of behavioral health. Although the HIV status of mothers alone did not predict youth mental health, youth knowledge of mother's HIV infection and mother's overall health were associated with worse youth mental health outcomes, as were contextual, self-regulation, and family interaction factors from our theoretical model. There is a need for family-based mental health interventions for this population, particularly focusing on parent-child relationships, disclosure, and youth self-esteem.
Zhang, Liying; Li, Xiaoming; Wang, Bo; Shen, Zhiyong; Zhou, Yuejiao; Xu, Jinping; Tang, Zhenzhu; Stanton, Bonita
2017-07-01
Intimate partner violence is prevalent among female sex workers (FSWs) in China, and it is significantly associated with mental health problems among FSWs. However, limited studies have explored the mechanisms/process by which violence affects mental health. The purpose of this study was to explore the relationships among partner violence, internalized stigma, and mental health problems among FSWs. Data were collected using a self-administered cross-sectional survey administered to 1,022 FSWs in the Guangxi Zhuang Autonomous Region (Guangxi), China during 2008-2009. We used structural equation modeling to test the hypothesized relationships. Results indicated that violence perpetrated by either stable sexual partners or clients was directly and positively associated with mental health problems. Violence also had an indirect relation to mental health problems through stigma. Results highlight the need for interventions on counseling and care for FSWs who have experienced violence and for interventions to increase FSWs' coping skills and empowerment strategies.
Mental health nursing and the politics of recovery: a global reflection.
Barker, Phil J; Buchanan-Barker, Poppy
2011-10-01
The concept of recovery increasingly dominates mental health policy and practice agendas in most Western countries. However, the many, often conflicting, definitions of recovery have led to theoretical and practical confusion. More importantly, the concept clashes with some of the established assumptions of psychiatric/mental health nursing, especially the traditional notion that the person is "ill" and requires "treatment" or some other active "intervention." The implications of recovery for the further development of person-centered care, especially within a globalized form of mental health nursing, are discussed with specific reference to the Tidal Model, an international midrange theory of mental health nursing. Copyright © 2011. Published by Elsevier Inc.
Lee, Eun-Jeong; Chan, Fong; Ditchman, Nicole; Feigon, Maia
2014-01-01
Asian students comprise over half of all international students in the United States, yet little is known about their help-seeking behaviors and preferences for mental health professionals. The purpose of this study was to use conjoint analysis to examine characteristics of mental health professionals influencing Korean international students' preferences when choosing a mental health professional. Korean international students from three universities in the United States were recruited on a volunteer basis to participate in this study (N = 114). Results indicated that mental health professional characteristics, including ethnicity, age, professional identity, and training institution, were significant factors in students' preference formation; however, gender of the mental health professional was not found to be a significant factor in the present study. Ethnic similarity was the most powerful predictor of preference formation. Implications for promoting help-seeking and mental health service utilization among Asian international students are discussed.
Mashiach–Eizenberg, Michal; Hasson-Ohayon, Ilanit; Yanos, Philip T.; Lysaker, Paul H.; Roe, David
2013-01-01
Research has revealed the negative consequences of internalized stigma among people with serious mental illness (SMI), including reductions in self-esteem and hope. The purpose of the present study was to investigate the relation between internalized stigma and subjective quality of life (QoL) by examining the mediating role of self-esteem and hope. Measures of internalized stigma, self-esteem, QoL, and hope were administrated to 179 people who had a SMI. Linear regression analysis and Structural Equation Modeling (SEM) were used to analyze the cross-sectional data. Self-esteem mediated the relation between internalized stigma and hope. In addition, hope partially mediated the relationship between self-esteem and QoL. The findings suggest that the effect of internalized stigma upon hope and QoL may be closely related to levels of self-esteem. This may point to the need for the development of interventions that target internalized stigma as well as self-esteem. PMID:23570969
Janssen, Ian
2016-11-01
The primary objective was to use isotemporal substitution models to estimate whether replacing time spent in sedentary video games (SVGs) and active outdoor play (AOP) with active video games (AVGs) would be associated with changes in youth's mental health. A representative sample of 20,122 Canadian youth in Grades 6-10 was studied. The exposure variables were average hours/day spent playing AVGs, SVGs, and AOP. The outcomes consisted of a negative and internalizing mental health indicator (emotional problems), a positive and internalizing mental health indicator (life satisfaction), and a positive and externalizing mental health indicator (prosocial behavior). Isotemporal substitution models estimated the extent to which replacing time spent in SVGs and AOP with an equivalent amount of time in AVGs had on the mental health indicators. Replacing 1 hour/day of SVGs with 1 hour/day of AVGs was associated with a 6% (95% confidence interval: 3%-9%) reduced probability of high emotional problems, a 4% (2%-7%) increased probability of high life satisfaction, and a 13% (9%-16%) increased probability of high prosocial behavior. Replacing 1 hour/day of AOP with 1 hour/day of AVGs was associated with a 7% (3%-11%) increased probability of high emotional problems, a 3% (1%-5%) reduced probability of high life satisfaction, and a 6% (2%-9%) reduced probability of high prosocial behavior. Replacing SVGs with AVGs was associated with more preferable mental health indicators. Conversely, replacing AOP with AVGs was associated with more deleterious mental health indicators. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Amone-P'Olak, Kennedy; Stochl, Jan; Ovuga, Emilio; Abbott, Rosemary; Meiser-Stedman, Richard; Croudace, Tim J; Jones, Peter B
2014-05-01
War experiences (WE) and postwar environments (PWE) are associated with mental ill-health. The present study aims to investigate the pathways from WE and PWE to mental ill-health and to define opportunities for intervention through analysis of the war-affected youths study (WAYS) cohort study. WAYS is an ongoing study of a large cohort of former child soldiers being conducted in Uganda. Mental health problems, subjective WE and PWE contexts were assessed by local adaptations of internationally developed measures for use with former child soldiers at least 6 years after the end of the war. Structural equation modeling was used to test two mediation hypotheses: (1) the 'trauma model' in which WE directly influence long-term mental health and (2) the 'psychosocial path' in which WE influence long-term mental health through PWE stressors. WE were linked to depression/anxiety (β=0.15 (95% CI 0.01 to 0.30)) through PWE (accounting for 44% of the variance in the relationship between these variables) and to conduct problems (β=0.23 (95% CI 0.03 to 0.43); (accounting for 89% of the variance, ie, near complete mediation)). The direct relation between WE and depression/anxiety attenuated but remained statistically significant. For conduct problems, the direct relationship was no longer significant after accounting for PWE. PWE are a key determinant of continued mental health problems in former child soldiers. Interventions to reduce long-term mental problems should address both PWE stressors (psychosocial model) and specialised mental healthcare (trauma model) and consider both models of intervention as complementary.
Quinn, Diane M; Williams, Michelle K; Weisz, Bradley M
2015-06-01
Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future and how anticipation of stigma in turn predicts greater stigma internalization. Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers. Correlational analyses indicated that more experiences of discrimination due to one's mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma. Experiences of discrimination over one's lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma. (c) 2015 APA, all rights reserved).
The presentation of depression in the British Army.
Finnegan, Alan; Finnegan, Sara; Thomas, Mike; Deahl, Martin; Simpson, Robin G; Ashford, Robert
2014-01-01
The British Army is predominately composed of young men, often from disadvantaged backgrounds, in which Depression is a common mental health disorder. To construct a predictive model detailing the presentation of depression in the army that could be utilised as an educational and clinical guideline for Army clinical personnel. Utilising a Constructivist Grounded Theory, phase 1 consisted of 19 interviews with experienced Army mental health clinicians. Phase 2 was a validation exercise conducted with 3 general practitioners. Depression in the Army correlates poorly with civilian definitions, and has a unique interpretation. Young soldiers presented with symptoms not in the International Classification of Disorders and older soldiers who feared being medically downgraded, sought help outside the Army Medical Services. Women found it easier to seek support, but many were inappropriately labelled as depressed. Implications include a need to address the poor understanding of military stressors; their relationships to depressive symptoms and raise higher awareness of gender imbalances with regard to access and treatment. The results have international implications for other Armed forces, and those employed in Young Men's Mental Health. The results are presented as a simple predictive model and aide memoire that can be utilised as an educational and clinical guideline. There is scope to adapt this model to international civilian healthcare practice. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
A metastructural model of mental disorders and pathological personality traits.
Wright, A G C; Simms, L J
2015-08-01
Psychiatric co-morbidity is extensive in both psychiatric settings and the general population. Such co-morbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions - internalizing, externalizing and psychoticism - can account for much of the observed covariation among common mental disorders. However, the location of personality disorders within this emerging metastructure has only recently been studied, and no studies have yet examined where pathological personality traits fit within such a broad metastructural framework. We conducted joint structural analyses of common mental disorders, personality disorders and pathological personality traits in a sample of 628 current or recent psychiatric out-patients. Bridging across the psychopathology and personality trait literatures, the results provide evidence for a robust five-factor metastructure of psychopathology, including broad domains of symptoms and features related to internalizing, disinhibition, psychoticism, antagonism and detachment. These results reveal evidence for a psychopathology metastructure that (a) parsimoniously accounts for much of the observed covariation among common mental disorders, personality disorders and related personality traits, and (b) provides an empirical basis for the organization and classification of mental disorder.
Van Beusekom, Gabriël; Bos, Henny Mw; Kuyper, Lisette; Overbeek, Geertjan; Sandfort, Theo Gm
2016-04-01
We assessed among a sample of 724 Dutch lesbian, gay, and bisexual-identified adults ( M age = 31.42) whether experiences with homophobic stigmatization and internalized homophobia simultaneously mediated the relation of gender nonconformity with mental health. Results indicated that homophobic stigmatization and internalized homophobia partially mediated the relation between gender nonconformity and mental health. Gender nonconformity was related to more mental health problems via increased experiences with homophobic stigmatization and to less mental health problems because of reduced levels of internalized homophobia. However, the mediated relation of gender nonconformity with mental health via homophobic stigmatization was only significant for men.
Roberts, Bayard; Damundu, Eliaba Yona; Lomoro, Olivia; Sondorp, Egbert
2010-08-27
There remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on general physical and mental health in Southern Sudan which is emerging from 20 years of armed conflict. A cross-sectional survey of 1228 adults was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Multivariate linear regression analysis was used to investigate the associations and relative influence of variables in three models of demographic characteristics, living conditions, and trauma exposure, on general physical and mental health status. These models were run separately and also as a combined model. Data quality and the internal consistency of the health status instrument (SF-8) were assessed. The variables in the multivariate analysis (combined model) with negative coefficients of association with general physical health and mental health (i.e. worse health), respectively, were being female (coef. -2.47; -2.63), higher age (coef.-0.16; -0.17), absence of soap in the household (physical health coef. -2.24), and experiencing within the past 12 months a lack of food and/or water (coef. -1.46; -2.27) and lack of medical care (coef.-3.51; -3.17). A number of trauma variables and cumulative exposure to trauma showed an association with physical and mental health (see main text for data). There was limited variance in results when each of the three models were run separately and when they were combined, suggesting the pervasive influence of these variables. The SF-8 showed good data quality and internal consistency. This study provides evidence on the pervasive influence of demographic characteristics, living conditions, and violent and traumatic events on the general physical and mental health of a conflict-affected population in Southern Sudan, and highlights the importance of addressing all these influences on overall health.
2010-01-01
Background There remains limited evidence on how armed conflict affects overall physical and mental well-being rather than specific physical or mental health conditions. The aim of this study was to investigate the influence of demographic characteristics, living conditions, and violent and traumatic events on general physical and mental health in Southern Sudan which is emerging from 20 years of armed conflict. Methods A cross-sectional survey of 1228 adults was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Multivariate linear regression analysis was used to investigate the associations and relative influence of variables in three models of demographic characteristics, living conditions, and trauma exposure, on general physical and mental health status. These models were run separately and also as a combined model. Data quality and the internal consistency of the health status instrument (SF-8) were assessed. Results The variables in the multivariate analysis (combined model) with negative coefficients of association with general physical health and mental health (i.e. worse health), respectively, were being female (coef. -2.47; -2.63), higher age (coef.-0.16; -0.17), absence of soap in the household (physical health coef. -2.24), and experiencing within the past 12 months a lack of food and/or water (coef. -1.46; -2.27) and lack of medical care (coef.-3.51; -3.17). A number of trauma variables and cumulative exposure to trauma showed an association with physical and mental health (see main text for data). There was limited variance in results when each of the three models were run separately and when they were combined, suggesting the pervasive influence of these variables. The SF-8 showed good data quality and internal consistency. Conclusions This study provides evidence on the pervasive influence of demographic characteristics, living conditions, and violent and traumatic events on the general physical and mental health of a conflict-affected population in Southern Sudan, and highlights the importance of addressing all these influences on overall health. PMID:20799956
Manwell, Laurie A; Barbic, Skye P; Roberts, Karen; Durisko, Zachary; Lee, Cheolsoon; Ware, Emma; McKenzie, Kwame
2015-06-02
Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health? 50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience. 46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented. Answers to the question, 'What are the core concepts of mental health?' are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Manwell, Laurie A; Barbic, Skye P; Roberts, Karen; Durisko, Zachary; Lee, Cheolsoon; Ware, Emma; McKenzie, Kwame
2015-01-01
Objective Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health? Design and participants 50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience. Results 46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented. Conclusions Answers to the question, ‘What are the core concepts of mental health?’ are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations. PMID:26038353
Wolchik, Sharlene A; Tein, Jenn-Yun; Sandler, Irwin N; Kim, Han-Joe
2016-08-01
A developmental cascade model from functioning in adolescence to emerging adulthood was tested using data from a 15-year longitudinal follow-up of 240 emerging adults whose families participated in a randomized, experimental trial of a preventive program for divorced families. Families participated in the program or literature control condition when the offspring were ages 9-12. Short-term follow-ups were conducted 3 months and 6 months following completion of the program when the offspring were in late childhood/early adolescence. Long-term follow-ups were conducted 6 years and 15 years after program completion when the offspring were in middle to late adolescence and emerging adulthood, respectively. It was hypothesized that the impact of the program on mental health and substance use outcomes in emerging adulthood would be explained by developmental cascade effects of program effects in adolescence. The results provided support for a cascade effects model. Specifically, academic competence in adolescence had cross-domain effects on internalizing problems and externalizing problems in emerging adulthood. In addition, adaptive coping in adolescence was significantly, negatively related to binge drinking. It was unexpected that internalizing symptoms in adolescence were significantly negatively related to marijuana use and alcohol use. Gender differences occurred in the links between mental health problems and substance use in adolescence and mental health problems and substance use in emerging adulthood.
Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.; Kim, Han-Joe
2017-01-01
A developmental cascade model from functioning in adolescence to emerging adulthood was tested using data from a 15-year longitudinal follow-up of 240 emerging adults whose families participated in a randomized, experimental trial of a preventive program for divorced families. Families participated in the program or literature control condition when the offspring were ages 9 – 12. Short-term follow-ups were conducted 3 months and 6 months following completion of the program when the offspring were in middle to late adolescence. Long-term follow-ups were conducted 6 years and 15 years after program completion when the offspring were in emerging adulthood. It was hypothesized that the impact of the program on mental health and substance use outcomes in emerging adulthood would be explained by developmental cascade effects of program effects in adolescence. The results provided support for a cascade effects model. Specifically, academic competence in adolescence had spillover effects on internalizing problems and externalizing problems in emerging adulthood. Also, adaptive coping in adolescence was significantly, negatively related to binge drinking. Unexpectedly, internalizing symptoms in adolescence were significantly negatively related to marijuana use and alcohol use. Gender differences occurred in the links between mental health and substance use outcomes in adolescence and mental health and substance use outcomes in emerging adulthood. PMID:27427811
ERIC Educational Resources Information Center
Shah, Avani; Wharton, Tracy; Scogin, Forrest
2017-01-01
Professional shortages of geriatrically trained social workers pose a barrier to mental health care for older adults. Integrating graduate social work interns into primary care settings may increase the availability of trained social workers. However, few studies provide guidance on how to develop an interprofessional healthcare placement focused…
ERIC Educational Resources Information Center
Martschinke, Sabine
1996-01-01
Examines types of graphical representation as to their suitability for knowledge acquisition in primary grades. Uses the concept of mental models to clarify the relationship between external presentation and internal representation of knowledge. Finds that students who learned with highly elaborated and highly structured pictures displayed the…
Quinn, Diane M.; Williams, Michelle K.; Weisz, Bradley M.
2015-01-01
Objective Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future, and how anticipation of stigma, in turn predicts greater stigma internalization. Method Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers. Results Correlational analyses indicated that more experiences of discrimination due to one’s mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma. Conclusion and Implications for Practice Experiences of discrimination over the lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma. PMID:25844910
Mental health-related discrimination as a predictor of low engagement with mental health services.
Clement, Sarah; Williams, Paul; Farrelly, Simone; Hatch, Stephani L; Schauman, Oliver; Jeffery, Debra; Henderson, R Claire; Thornicroft, Graham
2015-02-01
This study aimed to test the hypothesis that mental health-related discrimination experienced by adults receiving care from community mental health teams is associated with low engagement with services and to explore the pathways between these two variables. In this cross-sectional study, 202 adults registered with inner-city community mental health teams in the United Kingdom completed interviews assessing their engagement with mental health services (service user-rated version of the Service Engagement Scale), discrimination that they experienced because of mental illness, and other variables. Structural equation modeling was conducted to examine the relationship of experienced discrimination and service engagement with potential mediating and moderating variables, such as anticipated discrimination (Questionnaire on Anticipated Discrimination), internalized stigma (Internalized Stigma of Mental Illness Scale), stigma stress appraisal (Stigma Stress Appraisal), mistrust in services, the therapeutic relationship (Scale to Assess Therapeutic Relationships), difficulty disclosing information about one's mental health, and social support. Analyses controlled for age, race-ethnicity, and symptomatology. No evidence was found for a direct effect between experienced discrimination and service engagement. The total indirect effect of experienced discrimination on service engagement was statistically significant (coefficient=1.055, 95% confidence interval [CI]=.312-2.074, p=.019), mainly via mistrust in mental health services and therapeutic relationships (coefficient=.804, CI=.295-1.558, p=.019). A 1-unit increase in experienced discrimination via this pathway resulted in .804-unit of deterioration in service engagement. Findings indicate the importance of building and maintaining service users' trust in mental health services and in therapeutic relationships with professionals and countering the discrimination that may erode trust.
Drug use, mental health and problems related to crime and violence: cross-sectional study1
Claro, Heloísa Garcia; de Oliveira, Márcia Aparecida Ferreira; Bourdreaux, Janet Titus; Fernandes, Ivan Filipe de Almeida Lopes; Pinho, Paula Hayasi; Tarifa, Rosana Ribeiro
2015-01-01
Objective: to investigate the correlation between disorders related to the use of alcohol and other drugs and symptoms of mental disorders, problems related to crime and violence and to age and gender. Methods: cross-sectional descriptive study carried out with 128 users of a Psychosocial Care Center for Alcohol and other Drugs, in the city of São Paulo, interviewed by means of the instrument entitled Global Appraisal of Individual Needs - Short Screener. Univariate and multiple linear regression models were used to verify the correlation between the variables. Results: using univariate regression models, internalizing and externalizing symptoms and problems related to crime/violence proved significant and were included in the multiple model, in which only the internalizing symptoms and problems related to crime and violence remained significant. Conclusions: there is a correlation between the severity of problems related to alcohol use and severity of mental health symptoms and crime and violence in the study sample. The results emphasize the need for an interdisciplinary and intersectional character of attention to users of alcohol and other drugs, since they live in a socially vulnerable environment. PMID:26626010
Bassirnia, Anahita; Briggs, Jessica; Kopeykina, Irina; Mednick, Amy; Yaseen, Zimri; Galynker, Igor
2015-12-15
Internalized stigma of mental disorders has significant negative outcomes for patients with bipolar disorder and their families. The aim of this study is to evaluate the association between personality traits and internalized stigma of mental disorders in bipolar patients and their treatment partners. Five different questionnaires were utilized in this study: (1) Demographic data questionnaire, (2) Millon Clinical Multiaxial Inventory-III (MCMI-III) for personality traits, (3) Internalized Stigma of Mental Illness (ISMI) for stigma, (4) Self Report Manic Inventory (SRMI) for mania and (5) Center for Epidemiological Studies-Depression Scale (CES-D) for depression. The scores of personality traits were combined to create externalizing and internalizing personality trait scores. Results showed that patients with bipolar disorder and their treatment partners both experienced internalized stigma of mental health disorders. There was a significant positive correlation between internalized stigma and internalizing personality traits, but not externalizing traits. In a multi-variate regression analysis, internalizing personality trait score was found to be a significant predictor of internalized stigma. In conclusion, patients with bipolar disorder and their treatment partners perceive higher level of internalized stigma of mental disorders if they have internalizing personality traits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Feinstein, Brian A; Goldfried, Marvin R; Davila, Joanne
2012-10-01
The current study used path analysis to examine potential mechanisms through which experiences of discrimination influence depressive and social anxiety symptoms. The sample included 218 lesbians and 249 gay men (total N = 467) who participated in an online survey about minority stress and mental health. The proposed model included 2 potential mediators-internalized homonegativity and rejection sensitivity-as well as a culturally relevant antecedent to experiences of discrimination-childhood gender nonconformity. Results indicated that the data fit the model well, supporting the mediating roles of internalized homonegativity and rejection sensitivity in the associations between experiences of discrimination and symptoms of depression and social anxiety. Results also supported the role of childhood gender nonconformity as an antecedent to experiences of discrimination. Although there were not significant gender differences in the overall model fit, some of the associations within the model were significantly stronger for gay men than lesbians. These findings suggest potential mechanisms through which experiences of discrimination influence well-being among sexual minorities, which has important implications for research and clinical practice with these populations. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
The Resource Team: an innovative service delivery support model for mental health services.
O'Sullivan, Julie; Powell, Jacinta; Gibbon, Peter; Emmerson, Brett
2009-04-01
This paper outlines the development of the Resource Team, an innovative service delivery model supporting clinical services at the Inner North Brisbane Mental Health Service, Royal Brisbane and Women's Hospital Health Service District. The team aims to provide a base for specialist mental health support staff, improve knowledge management and support the development of meaningful community partnerships. Development of the team included a literature review and consultation with internal and external stakeholders. From this, the objectives, roles and functions of the team were clarified and disseminated to stakeholders. The team currently encompasses 12 positions and has initiated a number of programs and service developments. These include improved IT management of clinical resources and the development of partnerships with the community and non-government sectors. The Resource Team effectively coordinates specialist clinical support positions, addresses knowledge management issues and facilitates meaningful engagement with the community and non-government sectors. The model could easily be applied in other mental health and general health services.
Asakura, Nobuhiko; Inui, Toshio
2016-01-01
Two apparently contrasting theories have been proposed to account for the development of children's theory of mind (ToM): theory-theory and simulation theory. We present a Bayesian framework that rationally integrates both theories for false belief reasoning. This framework exploits two internal models for predicting the belief states of others: one of self and one of others. These internal models are responsible for simulation-based and theory-based reasoning, respectively. The framework further takes into account empirical studies of a developmental ToM scale (e.g., Wellman and Liu, 2004): developmental progressions of various mental state understandings leading up to false belief understanding. By representing the internal models and their interactions as a causal Bayesian network, we formalize the model of children's false belief reasoning as probabilistic computations on the Bayesian network. This model probabilistically weighs and combines the two internal models and predicts children's false belief ability as a multiplicative effect of their early-developed abilities to understand the mental concepts of diverse beliefs and knowledge access. Specifically, the model predicts that children's proportion of correct responses on a false belief task can be closely approximated as the product of their proportions correct on the diverse belief and knowledge access tasks. To validate this prediction, we illustrate that our model provides good fits to a variety of ToM scale data for preschool children. We discuss the implications and extensions of our model for a deeper understanding of developmental progressions of children's ToM abilities. PMID:28082941
Asakura, Nobuhiko; Inui, Toshio
2016-01-01
Two apparently contrasting theories have been proposed to account for the development of children's theory of mind (ToM): theory-theory and simulation theory. We present a Bayesian framework that rationally integrates both theories for false belief reasoning. This framework exploits two internal models for predicting the belief states of others: one of self and one of others. These internal models are responsible for simulation-based and theory-based reasoning, respectively. The framework further takes into account empirical studies of a developmental ToM scale (e.g., Wellman and Liu, 2004): developmental progressions of various mental state understandings leading up to false belief understanding. By representing the internal models and their interactions as a causal Bayesian network, we formalize the model of children's false belief reasoning as probabilistic computations on the Bayesian network. This model probabilistically weighs and combines the two internal models and predicts children's false belief ability as a multiplicative effect of their early-developed abilities to understand the mental concepts of diverse beliefs and knowledge access. Specifically, the model predicts that children's proportion of correct responses on a false belief task can be closely approximated as the product of their proportions correct on the diverse belief and knowledge access tasks. To validate this prediction, we illustrate that our model provides good fits to a variety of ToM scale data for preschool children. We discuss the implications and extensions of our model for a deeper understanding of developmental progressions of children's ToM abilities.
Risal, Ajay; Sharma, Pushpa Prasad; Sanjel, Seshananda
2013-01-01
Medical students tend to have a neutral or negative attitude to Psychiatry as a discipline. This study was initiated to explore the attitude towards mental illness and Psychiatry among the medical students and interns in Kathmandu University School of Medical Sciences. A cross-sectional questionnaire based study was conducted among the medical students and interns at Dhulikhel Hospital.Two self-rating scales; Attitudes towards Psychiatry-30 and Attitudes to Mental Illnesswere used to assess attitudes towards mental illness and Psychiatryamong the total 159 subjects. Descriptive statistics and independent sample t-test were applied using SPSS- 16 for analysis. Among the total 159 subjects, 44 (27.7%) were interns. Comparison of means of each item in Attitudes towards Psychiatry-30 and Attitudes to Mental Illnesswas done between males and females, medical students and interns, fi rst semester and ninth semester students. Most of the subjects showed neutral attitude towards all the scoring items; though there were a few signifi cant differences in mean scores of some items in group wise comparison. Overall attitudes towards mental illness and psychiatry among the medical students and interns in our medical school were positive or neutral. A further study with medical students from different institutions is needed to get a detail nationwide picture. attitude; interns; medical students; mental illness; psychiatry.
Decentering and Related Constructs: A Critical Review and Metacognitive Processes Model
Bernstein, Amit; Hadash, Yuval; Lichtash, Yael; Tanay, Galia; Shepherd, Kathrine; Fresco, David M.
2016-01-01
The capacity to shift experiential perspective—from within one’s subjective experience onto that experience—is fundamental to being human. Scholars have long theorized that this metacognitive capacity—which we refer to as decentering—may play an important role in mental health. To help illuminate this mental phenomenon and its links to mental health, we critically examine decentering-related constructs and their respective literatures (e.g., self-distanced perspective, cognitive distancing, cognitive defusion). First, we introduce a novel metacognitive processes model of decentering. Specifically, we propose that, to varying degrees, decentering-related constructs reflect a common mental phenomenon subserved by three interrelated metacognitive processes: meta-awareness, disidentification from internal experience, and reduced reactivity to thought content. Second, we examine extant research linking decentering-related constructs and their underlying metacognitive processes to mental health. We conclude by proposing future directions for research that transcends decentering-related constructs in an effort to advance the field’s understanding of this facet of human experience and its role in (mal)adaptation. PMID:26385999
Impacts of family and community violence exposure on child coping and mental health.
Mohammad, Esror Tamim; Shapiro, Ester R; Wainwright, Laurel D; Carter, Alice S
2015-02-01
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 uniquely associated with PTSD, and community violence with anxiety and aggression. Latent interaction tests revealed that ERC moderated relations between family abuse and anxiety, aggression and PTSD. Emotionally-regulated coping appears to play a protective role for children's mental health in contexts of violence exposure, offering opportunities for intervention and prevention.
Measuring the quality of interprofessional collaboration in child mental health collaborative care
Rousseau, Cécile; Laurin-Lamothe, Audrey; Nadeau, Lucie; Deshaies, Suzanne; Measham, Toby
2012-01-01
Objective This pilot study examines the potential utility of the Perception of Interprofessional Collaboration Model and the shared decision-making scales in evaluating the quality of partnership in child mental health collaborative care. Methods Ninety-six primary care professionals working with children and youth responded to an internet survey which included the Perception of Interprofessional Collaboration Model scale (PINCOM-Q) and an adapted version of a shared decision-making scale (Échelle de confort décisionnel, partenaire—ECD-P). The perceptions of child mental health professionals were compared with those of other professionals working with children. Results The PINCOM-Q and the ECD-P scales had an excellent internal consistency and they were moderately correlated. Child mental health professionals’ Individual Interprofessional Collaboration scores from the PINCOM-Q individual aspects subscale were better than that of other child professionals. Conclusion These scales may be interesting instruments to measure the quality of partnership in child mental health collaborative care settings. Research needs to replicate these findings and to determine whether the quality of collaboration is a predictor of mental health outcome.
Measuring the quality of interprofessional collaboration in child mental health collaborative care
Rousseau, Cécile; Laurin-Lamothe, Audrey; Nadeau, Lucie; Deshaies, Suzanne; Measham, Toby
2012-01-01
Objective This pilot study examines the potential utility of the Perception of Interprofessional Collaboration Model and the shared decision-making scales in evaluating the quality of partnership in child mental health collaborative care. Methods Ninety-six primary care professionals working with children and youth responded to an internet survey which included the Perception of Interprofessional Collaboration Model scale (PINCOM-Q) and an adapted version of a shared decision-making scale (Échelle de confort décisionnel, partenaire—ECD-P). The perceptions of child mental health professionals were compared with those of other professionals working with children. Results The PINCOM-Q and the ECD-P scales had an excellent internal consistency and they were moderately correlated. Child mental health professionals’ Individual Interprofessional Collaboration scores from the PINCOM-Q individual aspects subscale were better than that of other child professionals. Conclusion These scales may be interesting instruments to measure the quality of partnership in child mental health collaborative care settings. Research needs to replicate these findings and to determine whether the quality of collaboration is a predictor of mental health outcome. PMID:22371692
International Student Mental Health
ERIC Educational Resources Information Center
Prieto-Welch, Susan L.
2016-01-01
This chapter describes the mental health status of international students in institutions of higher education, unique challenges these students face and their impact on mental health, and suggestions for ways to address these challenges.
Mashiach-Eizenberg, Michal; Hasson-Ohayon, Ilanit; Yanos, Philip T; Lysaker, Paul H; Roe, David
2013-06-30
Research has revealed the negative consequences of internalized stigma among people with serious mental illness (SMI), including reductions in self-esteem and hope. The purpose of the present study was to investigate the relation between internalized stigma and subjective quality of life (QoL) by examining the mediating role of self-esteem and hope. Measures of internalized stigma, self-esteem, QoL, and hope were administrated to 179 people who had a SMI. Linear regression analysis and structural equation modeling (SEM) were used to analyze the cross-sectional data. Self-esteem mediated the relation between internalized stigma and hope. In addition, hope partially mediated the relationship between self-esteem and QoL. The findings suggest that the effect of internalized stigma upon hope and QoL may be closely related to levels of self-esteem. This may point to the need for the development of interventions that target internalized stigma as well as self-esteem. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Mental maps and travel behaviour: meanings and models
NASA Astrophysics Data System (ADS)
Hannes, Els; Kusumastuti, Diana; Espinosa, Maikel León; Janssens, Davy; Vanhoof, Koen; Wets, Geert
2012-04-01
In this paper, the " mental map" concept is positioned with regard to individual travel behaviour to start with. Based on Ogden and Richards' triangle of meaning (The meaning of meaning: a study of the influence of language upon thought and of the science of symbolism. International library of psychology, philosophy and scientific method. Routledge and Kegan Paul, London, 1966) distinct thoughts, referents and symbols originating from different scientific disciplines are identified and explained in order to clear up the notion's fuzziness. Next, the use of this concept in two major areas of research relevant to travel demand modelling is indicated and discussed in detail: spatial cognition and decision-making. The relevance of these constructs to understand and model individual travel behaviour is explained and current research efforts to implement these concepts in travel demand models are addressed. Furthermore, these mental map notions are specified in two types of computational models, i.e. a Bayesian Inference Network (BIN) and a Fuzzy Cognitive Map (FCM). Both models are explained, and a numerical and a real-life example are provided. Both approaches yield a detailed quantitative representation of the mental map of decision-making problems in travel behaviour.
Gillard, S; Gibson, S L; Holley, J; Lucock, M
2015-10-01
A range of peer worker roles are being introduced into mental health services internationally. There is some evidence that attests to the benefits of peer workers for the people they support but formal trial evidence in inconclusive, in part because the change model underpinning peer support-based interventions is underdeveloped. Complex intervention evaluation guidance suggests that understandings of how an intervention is associated with change in outcomes should be modelled, theoretically and empirically, before the intervention can be robustly evaluated. This paper aims to model the change mechanisms underlying peer worker interventions. In a qualitative, comparative case study of ten peer worker initiatives in statutory and voluntary sector mental health services in England in-depth interviews were carried out with 71 peer workers, service users, staff and managers, exploring their experiences of peer working. Using a Grounded Theory approach we identified core processes within the peer worker role that were productive of change for service users supported by peer workers. Key change mechanisms were: (i) building trusting relationships based on shared lived experience; (ii) role-modelling individual recovery and living well with mental health problems; (iii) engaging service users with mental health services and the community. Mechanisms could be further explained by theoretical literature on role-modelling and relationship in mental health services. We were able to model process and downstream outcomes potentially associated with peer worker interventions. An empirically and theoretically grounded change model can be articulated that usefully informs the development, evaluation and planning of peer worker interventions.
Mental models, metaphors and their use in the education of nurses.
Burke, L M; Wilson, A M
1997-11-01
A great deal of nurses' confidence in the use of information technology (IT) depends both on the way computers are introduced to students in the college and how such education is continued and applied when they are practitioners. It is therefore vital that teachers of IT assist nurses to discover ways of learning to utilize and apply computers within their workplace with whatever methods are available. One method which has been introduced with success in other fields is the use of mental models and metaphors. Mental models and metaphors enable individuals to learn by building on past learning. Concepts and ideas which have already been internalized from past experience can be transferred and adapted for usage in a new learning situation with computers and technology. This article explores the use of mental models and metaphors for the technological education of nurses. The concepts themselves will be examined, followed by suggestions for possible applications specifically in the field of nursing and health care. Finally the role of the teacher in enabling improved learning as a result of these techniques will be addressed.
Effect of arousal on internal clock speed in real action and mental imagery.
Ozel, Sylvie; Larue, Jacques; Dosseville, Fabrice
2004-09-01
The possible implication of an internal clock as a mechanism accounting for the temporal homology between actual and mental walking is studied. To observe this phenomenon, stressful sound stimuli were used to increase arousal, which is known to activate the internal clock. Seventeen participants performed three tasks: (1) a time production task, used as a reference task reflecting the internal clock speed; (2) an actual walking task; and (3) a mental walking task, all three in two sound conditions (no noise and noise). The results showed a significant effect of arousal on time in each task. The effect of noise, increasing the arousal level, was greater in time production and mental imagery tasks than in real action. In addition, the percentages of change between the two sound conditions for actual and mental walking time were not statistically different. These findings are further evidence of the existence of a timing process common to actual and mental walking. The data are consistent with the implication of an internal clock in both actual and mental walking.
Cleary, A; Dowling, M
2009-08-01
Recovery is the model of care presently advocated for mental health services internationally. The aim of this study was to examine the knowledge and attitudes of mental health professionals to the concept of recovery in mental health. A descriptive survey approach was adopted, and 153 health care professionals (nurses, doctors, social workers, occupational therapists and psychologists) completed an adapted version of the Recovery Knowledge Inventory. The respondents indicated their positive approach to the adoption of recovery as an approach to care in the delivery of mental health services. However, respondents were less comfortable in encouraging healthy risk taking with service users. This finding is important because therapeutic risk taking and hope are essential aspects in the creation of a care environment that promotes recovery. Respondents were also less familiar with the non-linearity of the recovery process and placed greater emphasis on symptom management and compliance with treatment. Multidisciplinary mental health care teams need to examine their attitudes and approach to a recovery model of care. The challenge for the present and into the future is to strive to equip professionals with the necessary skills in the form of information and training.
Mental Health: An Interdisciplinary and International Perspective.
ERIC Educational Resources Information Center
Klineberg, Otto
The World Federation for Mental Health was founded as an international apolitical organization concerned with quality of life rather than merely the absence or prevention of mental illness. An examination of the manner and extent to which mental problems arise in different cultural settings can provide data needed to understand the relationship…
School Mental Health Promotion and Intervention: Experiences from Four Nations
ERIC Educational Resources Information Center
Weist, Mark D.; Bruns, Eric J.; Whitaker, Kelly; Wei, Yifeng; Kutcher, Stanley; Larsen, Torill; Holsen, Ingrid; Cooper, Janice L.; Geroski, Anne; Short, Kathryn H.
2017-01-01
All around the world, partnerships among schools and other youth-serving systems are promoting more comprehensive school-based mental health services. This article describes the development of international networks for school mental health (SMH) including the International Alliance for Child and Adolescent Mental Health and Schools (INTERCAMHS)…
Oosterwijk, Suzanne; Winkielman, Piotr; Pecher, Diane; Zeelenberg, René; Rotteveel, Mark; Fischer, Agneta H
2012-01-01
Mental states-such as thinking, remembering, or feeling angry, happy, or dizzy-have a clear internal component. We feel a certain way when we are in these states. These internal experiences may be simulated when people understand conceptual references to mental states. However, mental states can also be described from an "external" perspective, for example when referring to "smiling." In those cases, simulation of visible outside features may be more relevant for understanding. In a switching costs paradigm, we presented semantically unrelated sentences describing emotional and nonemotional mental states while manipulating their internal or external focus. The results show that switching costs occur when participants shift between sentences with an internal and an external focus. This suggests that different forms of simulation underlie understanding these sentences. In addition, these effects occurred for emotional and nonemotional mental states, suggesting that they are grounded in a similar way-through the process of simulation.
Lucksted, Alicia; Drapalski, Amy; Calmes, Christine; Forbes, Courtney; DeForge, Bruce; Boyd, Jennifer
2011-01-01
This study evaluated "Ending Self-Stigma" (ESS), a structured 9-session group intervention to help people with serious mental illnesses reduce internalized stigma. Participants from two Veterans Administration mental health sites were assessed before and after the intervention regarding their levels of internalized stigma, empowerment, recovery orientation, perceived social support, and beliefs about societal stigma. Internalized stigma significantly decreased, and perceived social support and recovery orientation significantly increased. "Ending Self-Stigma" is the first of its kind and may be a valuable intervention for reducing internalized stigma among people with serious mental illnesses, suitable for both professionally-delivered psychiatric rehabilitation programs and consumer-led programs and services.
BUILDING A WORKFORCE COMPETENCY-BASED TRAINING PROGRAM IN INFANT/EARLY CHILDHOOD MENTAL HEALTH.
Priddis, Lynn E; Matacz, Rochelle; Weatherston, Deborah
2015-01-01
This article describes findings from a project conducted in Western Australia (Mental Health Commission WA, 2015) that investigated the education and training needs of the Infant/Early Childhood Mental Health (I/ECMH) workforce. We examined international training programs and models of delivery in infant mental health, including a review of the current training available in Australia. Data collected from over 60 interviews were analyzed, and a staged delivery model for I/ECMH training and supervision that aligned with the Michigan Association for Infant Mental Health (2014) Competency Guidelines was recommended. These findings led to the purchase of the Michigan Association for Infant Mental Health (2014) for use in Western Australia. In a very short time, use of the Michigan Competency Framework by the Australian Association for Infant Mental Health West Australian Branch Incorporated has begun to change the training and education opportunities for upskilling the infant and early childhood workforce in Western Australia. It has resulted in a map to guide and develop training in the I/ECMH field for individual practitioners and professionals as well as for workplaces that will ultimately benefit Western Australian infants, young children, and their families during the perinatal period and in the early years. © 2015 Michigan Association for Infant Mental Health.
Sharaf, Amira Y; Ossman, Laila H; Lachine, Ola A
2012-12-01
Suicide is the major cause of premature death among individuals with schizophrenia. Ironically, one factor that heightens suicide risk is insight into mental illness. Little is known, however, about how insight contributes to suicidality. Recent evidence suggests that negative outcomes related to insight might depend on whether or not the individual accepts the stigmatizing beliefs about the mental illness. The present study examined the interactive effects of insight and internalized stigma on suicide risk in individuals with schizophrenia. We hypothesized that insight into mental illness and internalized stigma would increase suicide risk and that internalized stigma would moderate the effect of insight on suicide risk. A cross-sectional design was used in this study. A convenience sample of 200 individuals with schizophrenia was recruited from an outpatient clinic in the Eastern catchment area in Alexandria, Egypt. Eligible study participants were individuals with an illness duration not exceeding ten years, currently in outpatient treatment and follow-up, and post-acute or in a stable phase of their disorder. Individuals provided signed consent to participate and were interviewed to assess suicide risk, insight, internalized stigma of mental illness and depression. Slightly more than 38% of the study participants were classified as having a severe suicide risk. As predicted, suicide risk was positively associated with insight (r=.55, p<.001), internalized stigma (r=.79, p<.001), and depression (r=.78, p<.001). However, the influence of insight was not significant after controlling for covariates in the regression model (β=-.02, ns). Internalized stigma and depression independently predicted suicide risk, explaining 74% of variance in suicide risk, F(change) (6, 191)=11.54, p<.001. Greater insight was significantly linked to increased levels of internalized stigma (r=.59, p<.001) and depression (r=.61, p<.001). Internalized stigma did not moderate the influence of insight on suicide risk. The present study draws attention to the robust influence of internalized stigma in increasing suicide risk and suggests clinical approaches for managing internalized stigma and suicide risk among individuals with schizophrenia. Copyright © 2012 Elsevier Ltd. All rights reserved.
Zeegers, Moniek A J; Colonnesi, Cristina; Stams, Geert-Jan J M; Meins, Elizabeth
2017-12-01
Major developments in attachment research over the past 2 decades have introduced parental mentalization as a predictor of infant-parent attachment security. Parental mentalization is the degree to which parents show frequent, coherent, or appropriate appreciation of their infants' internal states. The present study examined the triangular relations between parental mentalization, parental sensitivity, and attachment security. A total of 20 effect sizes (N = 974) on the relation between parental mentalization and attachment, 82 effect sizes (N = 6,664) on the relation between sensitivity and attachment, and 24 effect sizes (N = 2,029) on the relation between mentalization and sensitivity were subjected to multilevel meta-analyses. The results showed a pooled correlation of r = .30 between parental mentalization and infant attachment security, and rs of .25 for the correlations between sensitivity and attachment security, and between parental mentalization and sensitivity. A meta-analytic structural equation model was performed to examine the combined effects of mentalization and sensitivity as predictors of infant attachment. Together, the predictors explained 12% of the variance in attachment security. After controlling for the effect of sensitivity, the relation between parental mentalization and attachment remained, r = .24; the relation between sensitivity and attachment remained after controlling for parental mentalization, r = .19. Sensitivity also mediated the relation between parental mentalization and attachment security, r = .07, suggesting that mentalization exerts both direct and indirect influences on attachment security. The results imply that parental mentalization should be incorporated into existing models that map the predictors of infant-parent attachment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Stirling, Yolande; Higgins, Kate; Petrakis, Melissa
2018-02-01
Objective Although Australia's service and policy context differs from that of the US, studies have highlighted potential for individual placement and support (IPS) to support competitive employment outcomes for people with severe and persistent mental illness. The aim of the present study was to explore why the model is not yet widely available. Methods A document analysis was conducted to discern reasons for challenges in implementation of IPS practice principles within the Australian service context. Results The document analysis illustrated that although policy acknowledges the importance of increasing employment rates for people with severe and persistent mental illness, consistent measures, change indicators, direction and time frames are lacking in policy and strategy documentation. Further, IPS principles are not consistently evident in guiding operational documentation that government-funded Disability Employment Services (DES) programs are mandated to adhere to. Conclusions For IPS to be readily implemented, it is necessary for government to offer support to agencies to partner and formal endorsement of the model as a preferred approach in tendering processes. Obligations and processes must be reviewed to ensure that model fidelity is achievable within the Australian Commonwealth policy and service context for programs to achieve competitive employment rates comparable to the most successful international programs. What is known about the topic? The IPS model has been established as the most efficacious approach to support people with severe and persistent mental ill health to gain and sustain employment internationally, yet little is known as to why this model has had very limited uptake in the Australian adult mental health service and policy context. What does this paper add? This paper provides an investigation into the achievability of IPS within DES philosophical and contractual arrangements. What are the implications for practitioners? Mental health practitioners are typically skilled in their understanding of individual or micro-level challenges faced by consumers in achieving vocational goals: working with symptoms, medication side effects, motivation and anxiety. The present study was designed to offer practitioners an increased understanding of service-level factors, because these present considerable challenges to achieving sustained employment. This paper is a call for greater advocacy towards better integration of employment and mental health service delivery in the Australian policy and practice context.
Hecker, Tobias; Hermenau, Katharin; Salmen, Charlotte; Teicher, Martin; Elbert, Thomas
2016-04-29
Child maltreatment poses a risk to children and adolescents' mental health and may also affect cognitive functioning. Also harsh discipline has been frequently associated with mental health problems. However, within societies in which harsh disciplinary methods are culturally normed and highly prevalent less is known about the association between harsh punishment, mental health problems, and cognitive functioning. In a cross-sectional study, we conducted structured clinical interviews with a sample of Tanzanian primary school students assessing exposure to harsh discipline (Maltreatment and Abuse Chronology of Exposure), internalizing problems (Strength and Difficulties Questionnaire, Children's Depression Inventory), and working memory (Corsi Blocktapping Task). School performance was measured by using the exam grades in 4 core subjects. The 409 children (52% boys) had a mean age of 10.5 years (range: 6 - 15). Using structural equation modeling, a strong relationship was found between harsh discipline and internalizing problems (β = .47), which were related to lower working memory capacity (β = -.17) and school performance (β = -.17). The present study suggests that harsh discipline is closely linked to children's internalizing mental health problems, which are in turn associated with lower cognitive functioning and school performance. Given the high rates of harsh discipline experienced by children in East African homes and elsewhere, the findings of the present study emphasize the need to inform the population at large about the potentially adverse consequences associated with harsh discipline.
Mental Health Utilization Among Diverse Parenting Young Couples.
Albritton, Tashuna; Angley, Meghan; Gibson, Crystal; Sipsma, Heather; Kershaw, Trace
2015-09-01
Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social-personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor-Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow-up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse's influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.
The Role of a Mental Model in Learning to Operate a Device.
ERIC Educational Resources Information Center
Kieras, David E.; Bovair, Susan
1984-01-01
Describes three studies concerned with learning to operate a control panel device and how this learning is affected by understanding a device model that describes its internal mechanism. Results indicate benefits of a device model depend on whether it supports direct inference of exact steps required to operate the device. (Author/MBR)
[An explanatory model of behavior toward mental illness].
García-Sílberman, Sarah
2002-01-01
To evaluate a theoretical model designed to explain behaviors toward mental illness, considering some variables related to the construct. A survey was conducted in 1996 on mental disorder beliefs, attitudes, and behavioral intentions. The sample population was stratified by socioeconomic status, age, and gender. Study subjects were 800 individuals from Mexico City's general population. A data collection instrument was constructed and validated, consisting of 120 Likert-type items with five options each. Data were coded and analyzed with the software package SPSS. Internal consistency of the scales was assessed using Cronbach's alpha and construct validity with factorial analysis. Student's t test and ANOVA were used to compare the groups in the different strata. The model allowed to confirm the predictive capacity of the causal chain connecting beliefs, attitudes, and intentions; nevertheless, other study variables did not contribute to explain it, and behavior was scarcely influenced by intentions, depending mainly on experimented necessity. Study findings constitute a basis to understand the attitudes of shame and fear usually related to mental illnesses, to plan efficient actions aimed at modifying them, and to design programs to promote mental health. The English version of this paper is available at: http://www.insp.mx/salud/index.html.
Disgust as a Unique Affective Predictor of Mental Contamination Following Sexual Trauma
Badour, Christal L.; Ojserkis, Rachel; McKay, Dean; Feldner, Matthew T.
2014-01-01
Mental contamination has been described as an internal experience of dirtiness that can arise and persist in the absence of contact with observable physical contaminants. Recent research has examined mental contamination specifically related to unwanted physical contact and sexual trauma. This study evaluated the degree to which disgust propensity and both self-focused and perpetrator-focused peritraumatic disgust were associated with mental contamination in a sample of women who experienced sexual trauma (n = 72). Results showed that peritraumatic self-focused disgust, but not peritraumatic perpetrator-focused disgust or fear, was significantly associated with mental contamination. Additionally, disgust propensity contributed significantly to the incremental validity of the model. These findings support the nascent literature showing that disgust plays a significant role in mental contamination, particularly following sexual trauma. Future research directions, and clinical/theoretical implications of these results are discussed. PMID:25129888
Understanding the Stress Process of Chinese- and Korean-American Breast Cancer Survivors.
Paek, Min-So; Lim, Jung-Won
2016-10-01
Guided by the stress process model (SPM), this study investigated the direct and indirect pathways of primary (negative self-image and life stress), secondary stressors (family communication strain) and family coping (external and internal) on mental health outcomes among Chinese- and Korean-American breast cancer survivors (BCS). A total of 156 Chinese- and Korean-American BCS were surveyed. Results showed primary and secondary stressors had a negative effect on better mental health outcomes. External coping was associated with better mental health. Family communication strain mediated the relationship between life stress and mental health outcomes. External coping mediated the relationship between family communication strain and mental health outcomes. Multi-group analysis revealed the stress process did not differ across ethnic groups. Findings suggest the SPM may be applicable to understand the stress process of Chinese- and Korean-American BCS and provide valuable insight into the role of family communication and external coping on mental health outcomes.
Lombardi, Riccardo
2003-08-01
The author suggests that the use of mental models and language registers may help an analysis to proceed, especially in psychosis, when the patient has not yet developed a mental space that will allow him/her the functions of knowledge and containment of emotions. Models, according to Bion, are a primitive approach to abstraction and a manifestation of the analyst's reverie that enables him/her to transform sense data into alpha-elements. Ferrari, in a further development of Bion's theories, hypothesises a relationship between the transference and the internal level of body-mind communication, and proposes the use of language registers to sustain the psychoanalytic process. The author presents several clinical examples from a thirteen-year, four-session-a-week analysis of a psychotic analysand who was initially confused, paranoid and altogether unable to bring self-reflective thought to bear on her overwhelming emotions and had, by the end of the analysis, completely recovered from her psychotic symptoms. The clinical material shows how the technical tools of mental models and language registers helped in the construction of a mental space and spatio-temporal parameters, permitting the patient to tolerate overwhelming concrete emotions and finally to recognise and work through the emotions of an intense transference.
Development of lifetime comorbidity in the WHO World Mental Health (WMH) Surveys
Kessler, Ronald C.; Ormel, Johan; Petukhova, Maria; McLaughlin, Katie A.; Green, Jennifer Greif; Russo, Leo J.; Stein, Dan J.; Zaslavsky, Alan M; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura; Benjet, Corina; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Fayyad, John; Haro, Josep Maria; Hu, Chi yi; Karam, Aimee; Lee, Sing; Lepine, Jean-Pierre; Matchsinger, Herbert; Mihaescu-Pintia, Constanta; Posada-Villa, Jose; Sagar, Rajesh; Üstün, T. Bedirhan
2010-01-01
CONTEXT Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. OBJECTIVE To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the WHO World Mental Health (WMH) surveys. SETTING/PARTICIPANTS Nationally or regionally representative community surveys in 14 countries with a total of 21,229 respondents. MAIN OUTCOME MEASURES First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the WHO Composite International Diagnostic Interview (CIDI). RESULTS Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (i.e., internalizing or externalizing) associations were generally stronger than between-domain associations. The vast majority of time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity disorder and oppositional-defiant disorder (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. CONCLUSIONS The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered here. These common pathways should be the focus of future research on the development of comorbidity, although several important pair-wise associations that cannot be accounted for by latent variables also exist that warrant further focused study. PMID:21199968
Pérez-Garín, Daniel; Molero, Fernando; Bos, Arjan E R
2015-08-30
This study examines the relationships between internalized stigma, psychological well-being, and subjective well-being in a sample of people with mental illness. We conducted a cross-sectional study with 213 outpatients from the Spanish public social care network. The results showed that (a) internalized stigma was significantly negatively correlated with psychological well-being and subjective well-being (affect balance and life satisfaction) (all correlations are significant with at least p<0.05; most with p<0.001), (b) the two types of well-being were significantly positively correlated and regressions models were significant and (all correlations are at least p<0.01, and regression models are also significant), (c) the effect of internalized stigma on affect balance and life satisfaction was mediated by psychological well-being. The component of internalized stigma most consistently associated with both types of well-being was alienation (life satisfaction: B=-0.35, p=0.001; affect balance: B=-0.38, p=0.001). These findings should be confirmed in future longitudinal or experimental research. On the basis of these results we recommend that interventions to combat self-stigma aim to reduce feelings of alienation and improve self-acceptance and other aspects of positive psychological functioning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Betancourt, Theresa S; McBain, Ryan; Newnham, Elizabeth A; Brennan, Robert T
2014-03-01
Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics - social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth - in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in postconflict Sierra Leone. A total of 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively covaried with youths' externalizing and internalizing scores - indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p < .05). The relationship between collective efficacy and mental health outcomes was nonsignificant (p > .05). This study offers a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a 4-year period of follow-up. These results underscore the importance of the postconflict social environment and the need to develop postconflict interventions that address community-level processes in addition to the needs of families and individuals. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
Family process and youth internalizing problems: A triadic model of etiology and intervention.
Schleider, Jessica L; Weisz, John R
2017-02-01
Despite major advances in the development of interventions for youth anxiety and depression, approximately 30% of youths with anxiety do not respond to cognitive behavioral treatment, and youth depression treatments yield modest symptom decreases overall. Identifying networks of modifiable risk and maintenance factors that contribute to both youth anxiety and depression (i.e., internalizing problems) may enhance and broaden treatment benefits by informing the development of mechanism-targeted interventions. A particularly powerful network is the rich array of family processes linked to internalizing problems (e.g., parenting styles, parental mental health problems, and sibling relationships). Here, we propose a new theoretical model, the triadic model of family process, to organize theory and evidence around modifiable, transdiagnostic family factors that may contribute to youth internalizing problems. We describe the model's implications for intervention, and we propose strategies for testing the model in future research. The model provides a framework for studying associations among family processes, their relation to youth internalizing problems, and family-based strategies for strengthening prevention and treatment.
Internalized stigma and its psychosocial correlates in Korean patients with serious mental illness.
Kim, Woo Jung; Song, Youn Joo; Ryu, Hyun-Sook; Ryu, Vin; Kim, Jae Min; Ha, Ra Yeon; Lee, Su Jin; Namkoong, Kee; Ha, Kyooseob; Cho, Hyun-Sang
2015-02-28
We aimed to examine internalized stigma of patients with mental illness in Korea and identify the contributing factors to internalized stigma among socio-demographic, clinical, and psychosocial variables using a cross-sectional study design. A total of 160 patients were recruited from a university mental hospital. We collected socio-demographic data, clinical variables and administered self-report scales to measure internalized stigma and levels of self-esteem, hopelessness, social support, and social conflict. Internalized stigma was identified in 8.1% of patients in our sample. High internalized stigma was independently predicted by low self-esteem, high hopelessness, and high social conflict among the psychosocial variables. Our finding suggests that simple psychoeducation only for insight gaining cannot improve internalized stigma. To manage internalized stigma in mentally ill patients, it is needed to promote hope and self-esteem. We also suggest that a relevant psychosocial intervention, such as developing coping skills for social conflict with family, can help patients overcome their internalized stigma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Gabbard, Carl; Bobbio, Tatiana
2011-03-01
Several research studies indicate that children with developmental coordination disorder (DCD) show delays with an array of perceptual-motor skills. One of the explanations, based on limited research, is that these children have problems generating and/or monitoring a mental (action) representation of intended actions, termed the "internal modeling deficit" (IMD) hypothesis. According to the hypothesis, children with DCD have significant limitations in their ability to accurately generate and utilize internal models of motor planning and control. The focus of this review is on one of the methods used to examine action representation-motor imagery, which theorists argue provides a window into the process of action representation (e.g., Jeannerod, 2001 . Neural simulation of action: A unifying mechanism for motor cognition. Neuroimage, 14, 103-109.). Included in the review are performance studies of typically developing and DCD children, and possible brain structures involved.
Kaysen, Debra; Kulesza, Magdalena; Balsam, Kimberly F.; Rhew, Isaac C.; Blayney, Jessica A.; Lehavot, Keren; Hughes, Tonda L.
2014-01-01
Sexual minorities have higher rates of depression and anxiety than their heterosexual counterparts. This elevated risk of psychological distress has generally been hypothesized to be a result of the effects of discrimination including internalized negative beliefs about sexual minorities. However, little research has examined the role of various types of coping in mediating between internalized homophobia and mental health. We tested the direct relationship between internalized homophobia and psychological distress and evaluated general and sexual minority-specific coping strategies as potential mediators using structural equation modeling. Data are from a national sample of 1,099 young adult sexual minority women who were on average 20.86 (SD= 2.12) years old, participating in a study on mental health and substance use. The model demonstrated acceptable fit, χ2 (83) = 402.9, p <.001, CFI=.94, TLI=.92, SRMR= .07, and RMSEA=.06, accounting for 73% of variance in psychological distress. Greater use of maladaptive coping and less use of sexual minority-specific coping were associated with higher psychological distress. Although maladaptive coping mediated the relationship between internalized homophobia and psychological distress, sexual minority-specific coping did not. Our findings support previous studies that have demonstrated the impact of internalized homophobia on psychological distress as well as the role of coping as a protective/risk factor in this relationship. PMID:25530980
Kaysen, Debra; Kulesza, Magdalena; Balsam, Kimberly F; Rhew, Isaac C; Blayney, Jessica A; Lehavot, Keren; Hughes, Tonda L
2014-09-01
Sexual minorities have higher rates of depression and anxiety than their heterosexual counterparts. This elevated risk of psychological distress has generally been hypothesized to be a result of the effects of discrimination including internalized negative beliefs about sexual minorities. However, little research has examined the role of various types of coping in mediating between internalized homophobia and mental health. We tested the direct relationship between internalized homophobia and psychological distress and evaluated general and sexual minority-specific coping strategies as potential mediators using structural equation modeling. Data are from a national sample of 1,099 young adult sexual minority women who were on average 20.86 ( SD = 2.12) years old, participating in a study on mental health and substance use. The model demonstrated acceptable fit, χ 2 (83) = 402.9, p <.001, CFI =.94, TLI =.92, SRMR = .07, and RMSEA =.06, accounting for 73% of variance in psychological distress. Greater use of maladaptive coping and less use of sexual minority-specific coping were associated with higher psychological distress. Although maladaptive coping mediated the relationship between internalized homophobia and psychological distress, sexual minority-specific coping did not. Our findings support previous studies that have demonstrated the impact of internalized homophobia on psychological distress as well as the role of coping as a protective/risk factor in this relationship.
Hedemann, Erin R; Frazier, Stacy L
2017-09-01
This study examined a university-community partnership, focusing on mental health promotion within an after-school music program. We pursued two goals: (a) supporting staff around student engagement and behavior management; (b) integrating social-emotional activities into the curriculum. We assessed youth's mental health needs and examined feasibility of social-emotional activities delivered. One-hundred sixty-two youth participated in activities, while a subset of youth (n = 61) and their parents provided information on mental health need. Rates of anxiety and depression symptoms were high, and youth reported high satisfaction with the activities. Results suggest promise of this model for mental health promotion for urban youth.
Mental models for cognitive control
NASA Astrophysics Data System (ADS)
Schilling, Malte; Cruse, Holk; Schmitz, Josef
2007-05-01
Even so called "simple" organisms as insects are able to fastly adapt to changing conditions of their environment. Their behaviour is affected by many external influences and only its variability and adaptivity permits their survival. An intensively studied example concerns hexapod walking. 1,2 Complex walking behaviours in stick insects have been analysed and the results were used to construct a reactive model that controls walking in a robot. This model is now extended by higher levels of control: as a bottom-up approach the low-level reactive behaviours are modulated and activated through a medium level. In addition, the system grows up to an upper level for cognitive control of the robot: Cognition - as the ability to plan ahead - and cognitive skills involve internal representations of the subject itself and its environment. These representations are used for mental simulations: In difficult situations, for which neither motor primitives, nor whole sequences of these exist, available behaviours are varied and applied in the internal model while the body itself is decoupled from the controlling modules. The result of the internal simulation is evaluated. Successful actions are learned and applied to the robot. This constitutes a level for planning. Its elements (movements, behaviours) are embodied in the lower levels, whereby their meaning arises directly from these levels. The motor primitives are situation models represented as neural networks. The focus of this work concerns the general architecture of the framework as well as the reactive basic layer of the bottom-up architecture and its connection to higher level functions and its application on an internal model.
Xie, Shenghua
2017-11-10
Previous studies on the relationship between mental stress and the tobacco use of internal migrants have not fully considered the social context of the host society. This study aims to examine how mental stress influences cigarette smoking in internal migrants in China by considering the social context of the host society. We used the RUMiC data that were collected in 15 cities distributed throughout 9 provinces of China. A total of 8,446 and 5,426 migrant workers were interviewed in 2008 and 2009, respectively. We selected individuals based on the criteria of age, salary, and hukou status. A total of 8,880 observations are valid for this study. This research used the logistic regression method to test the association between mental stress and the tobacco use of internal migrants. The results show that mental stress is not necessarily associated with the tobacco use of internal migrants. However, the effects of mental stress on tobacco use are moderated by the social context of the host society. This article calls for more attention to be paid to the moderate effect of social context in the host society on the association between mental stress and cigarette smoking of internal migrants. Moreover, this article underscores the importance of factors related to local societies in making and enacting tobacco control policies for migrants in developing countries.
2016-01-01
performance. The model integrates the roles of internal (personal) and external ( environmental ) resources specifically for developing , sustaining, and... through these systems. Conclusion Adult education and adult learning is most effective when curriculum is experienced- based and the instructor...synthesis, integration and validation of knowledge derived through the scientific method. In NATO, S&T is addressed using different business models
RESILIENCE THEORY AND ITS IMPLICATIONS FOR CHINESE ADOLESCENTS.
Wang, Jin-Liang; Zhang, Da-Jun; Zimmerman, Marc A
2015-10-01
Over the past 20 years, resilience theory has attracted great attention from both researchers and mental health practitioners. Resilience is defined as a process of overcoming the negative effects of risk exposure, coping successfully with traumatic experiences, or avoiding the negative trajectories associated with risks. Three basic models of resilience have been proposed to account for the mechanism whereby promotive factors operate to alter the trajectory from risk exposure to negative consequences: compensatory model, protective model, and inoculation model. Assets and resources are two types of promotive factors found to be effective in decreasing internalizing and externalizing problems. Considering the protective or compensatory role of assets and resources in helping youth be resilient against negative effects of adversity, resilience could be applied to Chinese migrant and left-behind children who are at risk for internalizing (e.g., depression, anxiety) and externalizing problems (e.g., delinquent behaviors, cigarette and alcohol use). Additionally, psychological suzhi-based interventions, a mental health construct for individuals that focuses on a strengths-based approach, can be integrated with resilience-based approach to develop more balanced programs for positive youth development.
Karasz, Alison; Patel, Viraj; Kabita, Mahbhooba; Shimu, Parvin
2015-01-01
Background Though common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be due in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. CBPR is ideally suited to help address measurement issues in CMD as well as develop culturally appropriate treatment models. Objectives To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. Methods We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/ illness, “Tension,” as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. Results The 24-item “Tension Scale” had high internal consistency (alpha =0.83). In bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the PHQ-2, age, education, self-rated health, having seen a physician in the past year, and other variables. Conclusions Using participatory techniques, we created a new measure designed to assess common mental disorder in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder. PMID:24375184
Wartberg, L; Kriston, L; Kramer, M; Schwedler, A; Lincoln, T M; Kammerl, R
2017-06-01
Internet gaming disorder (IGD) has been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Currently, associations between IGD in early adolescence and mental health are largely unexplained. In the present study, the relation of IGD with adolescent and parental mental health was investigated for the first time. We surveyed 1095 family dyads (an adolescent aged 12-14 years and a related parent) with a standardized questionnaire for IGD as well as for adolescent and parental mental health. We conducted linear (dimensional approach) and logistic (categorical approach) regression analyses. Both with dimensional and categorical approaches, we observed statistically significant associations between IGD and male gender, a higher degree of adolescent antisocial behavior, anger control problems, emotional distress, self-esteem problems, hyperactivity/inattention and parental anxiety (linear regression model: corrected R 2 =0.41, logistic regression model: Nagelkerke's R 2 =0.41). IGD appears to be associated with internalizing and externalizing problems in adolescents. Moreover, the findings of the present study provide first evidence that not only adolescent but also parental mental health is relevant to IGD in early adolescence. Adolescent and parental mental health should be considered in prevention and intervention programs for IGD in adolescence. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Developing International Collaborations for Early Career Researchers in Psychology
Flanagan, Julianne C.; Barrett, Emma L.; Crome, Erica; Forbes, Miriam
2015-01-01
International collaboration is becoming increasingly vital as the emphasis on unmet need for mental health across cultures and nations grows. Opportunities exist for early career researchers to engage in international collaboration. However, little information is provided about such opportunities in most current psychology training models. The authors are early career researchers in psychology from U.S. and Australia who have developed a collaborative relationship over the past two years. Our goal is to increase awareness of funding opportunities to support international research and to highlight the benefits and challenges associated with international collaboration based on our experience. PMID:27453624
The psychiatric defence and international criminal law.
Tobin, John
2007-01-01
Following the development of the International Criminal Court (ICC) the mental state of the perpetrators of genocide, crimes against humanity and war crimes will become a more important issue in regard to defence and mitigating factors. This article examines how the International Criminal Tribunal for the Former Yugoslavia (ICTY) in particular has dealt with the mental illness defence to date, and how its judgements can serve as guidance for the ICC as it becomes the major international court of the future. The absence of a mental health defence in the Statutes of the ICTY and the International Criminal Tribunal for Rwanda has led to a reliance on the Rules of Procedure and Evidence of the two tribunals. There are major difficulties in using the mental health defence as it is defined in the Statutes of the ICC because of a requirement for the destruction of mental capacity as a valid defence. Fitness to plead and the defence of intoxication are also examined.
A survey of “mental hardiness” and “mental toughness” in professional male football players
2014-01-01
Background It is not uncommon for chiropractors to be associated with sports teams for injury prevention, treatment, or performance enhancement. There is increasing acceptance of the importance of sports psychology in the overall management of athletes. Recent findings indicate mental hardiness can be determined reliably using specific self-assessment questionnaires. This study set out to investigate the hardiness scores of professional footballers and examine the correlation between two questionnaires. It also included a mental hardiness rating of players by two coaches, and examined differences in hardiness and mental toughness between national and international players. Methods Two self-assessment questionnaires (modified Sports Mental Toughness Questionnaire [SMTQ-M] and Psychological Performance Inventory [PPI-A]) were completed by 20 male professional footballers. Two coaches, independently rated each player. A percentage score from each questionnaire was awarded each player and an average score was calculated ({SMTQ-M % + PPI-A %} ÷ 2). The PPI-A and SMTQ-M scores obtained for each player were analysed for correlation with Pearson’s correlation coefficient. Cohen’s kappa inter-reliability coefficient was used to determine agreement between coaches, and between the players’ hardiness scores and coaches’ ratings. The independent t-test was used to examine differences between national and international players. Results The players’ scores obtained from PPI-A and SMTQ-M correlated well (r = 0.709, p < 0.001). The coaches ratings showed significant, weak to moderate agreement (Cohen's kappa = 0.33). No significant agreement was found between player self-assessments and coaches’ ratings. The average ({SMTQ-M % + PPI-A %} ÷ 2) mean score was 77% (SD = 7.98) with international players scoring 7.4% (p = 0.04) higher than non-international players. Conclusions The questionnaires (SMTQ-M and PPI-A) correlated well in their outcome scores. These findings suggest that coaches moderately agree when assessing the level of mental hardiness of football players. There was no agreement between player self-assessment and ratings by coaches. Footballers who play or had played for national teams achieved slightly higher mental hardiness scores. Either questionnaire can offer the clinician a cost-effective, valuable measure of an individual’s psychological attributes, which could be relevant within the wider context of bio-psycho-social model of care. PMID:24735867
Tarullo, Amanda R; Youssef, Adriana; Frenn, Kristin A; Wiik, Kristen; Garvin, Melissa C; Gunnar, Megan R
2016-05-01
Internationally adopted postinstitutionalized (PI) children are at risk for lower levels of emotion understanding. This study examined how postadoption parenting influences emotion understanding and whether lower levels of emotion understanding are associated with behavior problems. Emotion understanding and parent mental state language were assessed in 3-year-old internationally adopted PI children (N = 25), and comparison groups of children internationally adopted from foster care (N = 25) and nonadopted (NA) children (N = 36). At 5.5-year follow-up, PI children had lower levels of emotion understanding than NA children, a group difference not explained by language. In the total sample, parent mental state language at age 3 years predicted 5.5-year emotion understanding after controlling for child language ability. The association of parent mental state language and 5.5-year emotion understanding was moderated by adoption status, such that parent mental state language predicted 5.5-year emotion understanding for the internationally adopted children, but not for the NA children. While postadoption experience does not erase negative effects of early deprivation on emotion understanding, results suggest that parents can promote emotion understanding development through mental state talk. At 5.5 years, PI children had more internalizing and externalizing problems than NA children, and these behavioral problems related to lower levels of emotion understanding.
Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani
2016-06-30
We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery. Published by Elsevier Ireland Ltd.
Sandfort, Theo; Bos, Henny; Knox, Justin; Reddy, Vasu
2016-04-01
Using data from a study about HIV risk among Black South African MSM, we aimed to ascertain whether unexpected findings about the relationship between gender nonconformity, discrimination, and mental health in this population, as reported by Cook, Sandfort, Nel, and Rich (2013), could be replicated, and to explore more in-depth how gender nonconformity relates to health. Cook et al. found that feminine men were not more likely to be depressed despite the observation that they were more likely to be discriminated against and that discrimination increased the likelihood of depression. This is in contrast to what studies among gay and bisexual men in Western countries have consistently shown. In the current study, 196 Black South African MSM (ages between 18 and 40; M age, 26.65 years) were surveyed. Assessments included stressors (identity confusion, internalized homophobia, and sexual orientation-based discrimination) and resilience factors (openness about one's sexual orientation, social support, and identification with the gay community). We observed that gender-nonconforming men were not more likely to be depressed despite having experienced more discrimination, which was associated with depression. The same relationships were observed when considering anxiety as the mental health outcome. We found an indirect negative effect of gender nonconformity on depression through internalized homophobia, suggesting that, in this population, internalized homophobia masks the effect of discrimination on mental distress. Implications for the sexual minority stress model, used to guide our analyses, are discussed. Further research is needed to disentangle the complex relationship between gender nonconformity and mental health among MSM populations.
International Students and Mental Health
ERIC Educational Resources Information Center
Forbes-Mewett, Helen; Sawyer, Anne-Maree
2016-01-01
Since the early 2000s, reports of increased rates of mental ill health among young people worldwide have received much attention. Several studies indicate a greater incidence of mental health problems among tertiary students, compared with the general population, and higher levels of anxiety, in particular, among international students compared…
Markon, Kristian E
2010-08-01
The literature suggests that internalizing psychopathology relates to impairment incrementally and gradually. However, the form of this relationship has not been characterized. This form is critical to understanding internalizing psychopathology, as it is possible that internalizing may accelerate in effect at some level of severity, defining a natural boundary of abnormality. Here, a novel method-semiparametric structural equation modeling-was used to model the relationship between internalizing and impairment in a sample of 8,580 individuals from the 2000 British Office for National Statistics Survey of Psychiatric Morbidity, a large, population-representative study of psychopathology. This method allows one to model relationships between latent internalizing and impairment without assuming any particular form a priori and to compare models in which the relationship is constant and linear. Results suggest that the relationship between internalizing and impairment is in fact linear and constant across the entire range of internalizing variation and that it is impossible to nonarbitrarily define a specific level of internalizing beyond which consequences suddenly become catastrophic in nature. Results demonstrate the phenomenological continuity of internalizing psychopathology, highlight the importance of impairment as well as symptoms, and have clear implications for defining mental disorder. Copyright 2010 APA, all rights reserved
Tekeli-Yesil, Sidika; Isik, Esra; Unal, Yesim; Aljomaa Almossa, Fuad; Konsuk Unlu, Hande; Aker, Ahmet Tamer
2018-07-01
To compare frequencies of some mental health disorders between Syrian refugees living in Turkey and internally displaced persons in Syria, and to identify factors associated with posttraumatic stress disorder and major depressive disorder. We carried out a field survey in May 2017 among 540 internally displaced persons in Syria and refugees in Turkey. The study revealed that mental disorders were highly prevalent in both populations. Major depressive disorder was more frequent among refugees in Turkey than among internally displaced persons in Syria; other mental disorders, including posttraumatic stress disorder, were more prevalent in the latter than in the former. Posttraumatic stress disorder was also associated with postmigration factors. Major depressive disorder was more likely among refugees in Turkey. In addition, the likelihood of major depressive disorder was predicted by stopping somewhere else before resettlement in the current location. The resettlement locus and the context and type of displacement seem to be important determinants of mental health disorders, with postmigration factors being stronger predictors of conflict-related mental health. Internally displaced persons may benefit more from trauma-focused approaches, whereas refugees may derive greater benefit from psychosocial approaches.
Meyer, Ilan H.
2007-01-01
In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress—explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications. PMID:12956539
Creative writing in recovery from severe mental illness.
King, Robert; Neilsen, Philip; White, Emma
2013-10-01
There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mental illness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well-received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mental illness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Utility of the Montreal assessment of need questionnaire for community mental health planning.
Tremblay, Jacques; Bamvita, Jean-Marie; Grenier, Guy; Fleury, Marie-Josée
2014-09-01
Needs assessment facilitates mental health services planning, provision, and evaluation. This study aimed to (a) validate a new instrument, the Montreal Assessment of Needs Questionnaire (MANQ), and (b) use this to assess variations and predictors of need (number and seriousness) in 297 individuals with severe mental disorders for 18 months, during implementation of the Quebec Mental Health Action Plan. MANQ internal and external validations were adequate. Variables significantly associated with need number and seriousness variations were used to build multiple linear regression models. Autonomous housing, not receiving welfare, not having consulted a health educator, higher level of help from services, Alcohol Use Disorders Identification Test total score, and social support were associated with decreasing need number and seriousness over time. Having a higher education was also associated with decreasing need number. In a reform context, the MANQ's unique ability to detect rapid improvement in patient needs has usefulness for Quebec mental health planning.
Van Loon, L M A; Van De Ven, M O M; Van Doesum, K T M; Hosman, C M H; Witteman, C L M
Children of parents with mental illness have an elevated risk of developing a range of mental health and psychosocial problems. Yet many of these children remain mentally healthy. The present study aimed to get insight into factors that protect these children from developing internalizing and externalizing problems. Several possible individual, parent-child, and family protective factors were examined cross-sectionally and longitudinally in a sample of 112 adolescents. A control group of 122 adolescents whose parents have no mental illness was included to explore whether the protective factors were different between adolescents with and without a parent with mental illness. Cross-sectional analyses revealed that high self-esteem and low use of passive coping strategies were related to fewer internalizing and externalizing problems. Greater self-disclosure was related to fewer internalizing problems and more parental monitoring was related to fewer externalizing problems. Active coping strategies, parental support, and family factors such as cohesion were unrelated to adolescent problem behavior. Longitudinal analyses showed that active coping, parental monitoring, and self-disclosure were protective against developing internalizing problems 2 years later. We found no protective factors for externalizing problems. Moderation analyses showed that the relationships between possible protective factors and adolescent problem behavior were not different for adolescents with and without a parent with mental illness. The findings suggest that adolescents' active coping strategies and parent-child communication may be promising factors to focus on in interventions aimed at preventing the development of internalizing problems by adolescents who have a parent with mental illness.
International Collaboration in Mental Health.
ERIC Educational Resources Information Center
Brown, Bertram S., Ed.; Torrey, E. Fuller, Ed.
Presented in five parts on research, services, training, drug abuse, and alcohol abuse are 31 reports of mental health studies and programs supported by the U.S. and other countries. Explained in the introduction are reasons the National Institute of Mental Health (NIMH) has supported international collaboration. The following are among subjects…
Examining a progressive model of self-stigma and its impact on people with serious mental illness.
Corrigan, Patrick W; Rafacz, Jennifer; Rüsch, Nicolas
2011-10-30
The self-esteem of some people with serious psychiatric disorders may be hurt by internalizing stereotypes about mental illness. A progressive model of self-stigma yields four stages leading to diminished self-esteem and hope: being aware of associated stereotypes, agreeing with them, applying the stereotypes to one's self, and suffering lower self-esteem. We expect to find associations between proximal stages - awareness and agreement - to be greater than between more distal stages: awareness and harm. The model was tested on 85 people with schizophrenia or other serious mental illnesses who completed measures representing the four stages of self-stigma, another independently-developed instrument representing self-stigma, proxies of harm (lowered self-esteem and hopelessness), and depression. These measures were also repeated at 6-month follow-up. Results were mixed but some evidence supported the progressive nature of self-stigma. Most importantly, separate stages of the progressive model were significantly associated with lowered self-esteem and hope. Implications of the model for stigma change are discussed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
ERIC Educational Resources Information Center
Bussey, Thomas J.
2013-01-01
Biochemistry education relies heavily on students' ability to visualize abstract cellular and molecular processes, mechanisms, and components. As such, biochemistry educators often turn to external representations to provide tangible, working models from which students' internal representations (mental models) can be constructed, evaluated, and…
Mental Health, School Problems, and Social Networks: Modeling Urban Adolescent Substance Use
ERIC Educational Resources Information Center
Mason, Michael J.
2010-01-01
This study tested a mediation model of the relationship with school problems, social network quality, and substance use with a primary care sample of 301 urban adolescents. It was theorized that social network quality (level of risk or protection in network) would mediate the effects of school problems, accounting for internalizing problems and…
[Comorbidity of substance use with mental disorders].
Leonidaki, V; Maliori, M
2009-01-01
This contribution reviews the international literature about dual diagnosis, meaning patients who have simultaneously mental health problems and substance use disorders and discusses epidemiology, clinical characteristics, but primarily etiopathogenesis and different treatment models and interventions. The epidemiological data coming from large-scale studies in the general population in USA, Australia and UK demonstrate the close relationship between mental health problems and substance use disorders. Also, the results from Greek research projects support this close relationship, but their research designs have significant limitations. Multiple and high risks are common in this population, like violent or suicidal behavior, self-harm, physical problems, while they appear less responsive to treatment. Subsequently, different models for etiopathogenesis of dual diagnosis have been suggested: (a) Causal relationship: secondary substance use disorder is subsequent of primary mental illness (self-medication hypothesis, supersenstivity model) or vice versa (alcohol, cannabis, and cocaine use trigger or contribute to development of mental illness). (b) Third factor as the cause of both mental and substance use disorders (genetic factor, neuropathology, traumatic experience, personality characteristics, multiple factors). (c) Comorbidty is due to chance. (d) Each disorder mutually exacerbates the other, regardless the cause. Here, the relationship between alcohol and depression is discussed further as example. The ideas and the research-evidence which support each of these models are presented. Also there is an overview of different treatment models: (a) Consecutive treatment: mental health treatment and substance misuse treatment are provided consecutively. (b) Parallel treatments: the patient attends programs of both mental health and substance use services simultaneously. (c) Integrated treatment: the same clinical team addresses both mental health issues and substance use disorders. The first two models have significant weaknesses due to lack of focus on the interaction of the different disorders or to administrative and managerial barriers. On the other hand, integrated programs appear to overcome these limitations. They use modified interventions provided by the same team in order to address the multiple needs of the patients. Different types of integrated programs are discussed. More pragmatist inter ventions should also be taken into consideration. It is expected that some direction for research and clinical practice to Greece will emerge from this contribution.
Understanding the Stress Process of Chinese- and Korean-American Breast Cancer Survivors
Lim, Jung-won
2017-01-01
Guided by the stress process model (SPM), this study investigated the direct and indirect pathways of primary (negative self-image and life stress), secondary stressors (family communication strain) and family coping (external and internal) on mental health outcomes among Chinese- and Korean-American breast cancer survivors (BCS). A total of 156 Chinese- and Korean-American BCS were surveyed. Results showed primary and secondary stressors had a negative effect on better mental health outcomes. External coping was associated with better mental health. Family communication strain mediated the relationship between life stress and mental health outcomes. External coping mediated the relationship between family communication strain and mental health outcomes. Multi-group analysis revealed the stress process did not differ across ethnic groups. Findings suggest the SPM may be applicable to understand the stress process of Chinese-and Korean-American BCS and provide valuable insight into the role of family communication and external coping on mental health outcomes. PMID:26223968
A concordance-based study to assess doctors’ and nurses’ mental models in Internal Medicine
Chan, K. C. Gary; Muller-Juge, Virginie; Cullati, Stéphane; Hudelson, Patricia; Maître, Fabienne; Vu, Nu V.; Savoldelli, Georges L.; Nendaz, Mathieu R.
2017-01-01
Interprofessional collaboration between doctors and nurses is based on team mental models, in particular for each professional’s roles. Our objective was to identify factors influencing concordance on the expectations of doctors’ and nurses’ roles and responsibilities in an Internal Medicine ward. Using a dataset of 196 doctor-nurse pairs (14x14 = 196), we analyzed choices and prioritized management actions of 14 doctors and 14 nurses in six clinical nurse role scenarios, and in five doctor role scenarios (6 options per scenario). In logistic regression models with a non-nested correlation structure, we evaluated concordance among doctors and nurses, and adjusted for potential confounders (including prior experience in Internal Medicine, acuteness of case and gender). Concordance was associated with number of female professionals (adjusted OR 1.32, 95% CI 1.02 to 1.73), for acute situations (adjusted OR 2.02, 95% CI 1.13 to 3.62), and in doctor role scenarios (adjusted OR 2.19, 95% CI 1.32 to 3.65). Prior experience and country of training were not significant predictors of concordance. In conclusion, our concordance-based approach helped us identify areas of lower concordance in expected doctor-nurse roles and responsibilities, particularly in non-acute situations, which can be targeted by future interprofessional, educational interventions. PMID:28792524
Betancourt, Theresa S; Yudron, Monica; Wheaton, Wendy; Smith-Fawzi, Mary C
2012-10-01
To examine the role of caregiver mental health and risk and protective factors in influencing levels of internalizing and externalizing emotional and behavioral symptoms over time among a sample of refugee adolescents. Prospective study of 153 Kunama refugee adolescents receiving an emergency education intervention while living in a camp in Ethiopia. Surveys were collected in 2001 (T1) and 2002 (T2). Adolescent and caregiver mental health were assessed using a Kunamenga adaptation of the Youth Self Report; caregiver mental health was assessed using the Hopkins Symptom Checklist-25. Attitudes toward education, satisfaction with education programming, socioeconomic status, and perceptions of access to services were also explored as variables potentially influencing adolescent mental health at follow-up. Caregiver distress was significantly associated with youth externalizing behavior symptoms (β = 8.34, p < .001) and internalizing symptoms (β = 4.02, p < .05). Caregiver perceived access to services had a protective effect on externalizing behaviors (β = -7.54, p < .05) and internalizing behaviors (β = -13.67, p < .001). Higher socioeconomic status (β = -1.47, p < .05) had a protective effect on internalizing symptoms. In terms of modifying effects, among youth with distressed caregivers, those who were satisfied with the International Rescue Committee education intervention had a lower internalizing score (β = -6.34, p < .001) compared with those who were not satisfied with the program. This study presents a rare prospective investigation of caregiver-adolescent mental health during an active refugee displacement. Results suggest that programs targeting mental health in refugee children should consider children within the larger family system, including caregiver influence on child and adolescent mental health adjustment over time. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Karasz, Alison; Patel, Viraj; Kabita, Mahbhooba; Shimu, Parvin
2013-01-01
Although common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be owing in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. Community-based participatory research (CBPR) is ideally suited to help address measurement issues in CMD as well as to develop culturally appropriate treatment models. To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/illness, "tension," as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. The 24-item "Tension Scale" had high internal consistency (α = 0.83). On bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the Patient Health Questionnaire (PHQ-2), age, education, self-rated health, having seen a physician in the past year, and other variables. Using participatory techniques, we created a new measure designed to assess CMD in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder.
Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China.
Lin, Danhua; Li, Xiaoming; Wang, Bo; Hong, Yan; Fang, Xiaoyi; Qin, Xiong; Stanton, Bonita
2011-04-01
Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being.
Bolt, Matthew A; Helming, Luralyn M; Tintle, Nathan L
2018-01-01
In 1986, Reactor 4 of the Chernobyl nuclear power plant near Pripyat, Ukraine exploded, releasing highly-radioactive materials into the surrounding environment. Although the physical effects of the disaster have been well-documented, a limited amount of research has been conducted on association of the disaster with long-term, clinically-diagnosable mental health disorders. According to the diathesis-stress model, the stress of potential and unknown exposure to radioactive materials and the ensuing changes to ones life or environment due to the disaster might lead those with previous vulnerabilities to fall into a poor state of mental health. Previous studies of this disaster have found elevated symptoms of stress, substance abuse, anxiety, and depression in exposed populations, though often at a subclinical level. With data from The World Mental Health Composite International Diagnostic Interview, a cross-sectional large mental health survey conducted in Ukraine by the World Health Organization, the mental health of Ukrainians was modeled with multivariable logistic regression techniques to determine if any long-term mental health disorders were association with reporting having lived in the zone affected by the Chernobyl nuclear disaster. Common classes of psychiatric disorders were examined as well as self-report ratings of physical and mental health. Reporting that one lived in the Chernobyl-affected disaster zone was associated with a higher rate of alcohol disorders among men and higher rates of intermittent explosive disorders among women in a prevalence model. Subjects who lived in the disaster zone also had lower ratings of personal physical and mental health when compared to controls. Stress resulting from disaster exposure, whether or not such exposure actually occurred or was merely feared, and ensuing changes in life circumstances is associated with increased rates of mental health disorders. Professionals assisting populations that are coping with the consequences of disaster should be aware of possible increases in psychiatric disorders as well as poorer perceptions regarding personal physical and mental health.
Mental Health and Education Decisions. CEE DP 136
ERIC Educational Resources Information Center
Cornaglia, Francesca; Crivellaro, Elena; McNally, Sandra
2012-01-01
Mental health problems--and depression in particular--have been rising internationally. The link between poor mental health and poor educational outcomes is particularly interesting in the case of the UK which has a low international ranking both on measures of child wellbeing and the probability of early drop-out from the labour market and…
Wilberforce, Mark; Tucker, Sue; Brand, Christian; Abendstern, Michele; Jasper, Rowan; Challis, David
2016-11-01
To evaluate the association between the degree of integration in community mental health teams (CMHTs) and: (i) the costs of service provision; (ii) rates of mental health inpatient and care home admission. An observational study of service use and admissions to institutional care was undertaken for a prospectively-sampled cohort of patients from eight CMHTs in England. Teams were chosen to represent 'high' or 'low' levels of integrated working practice and patients were followed-up for seven months. General linear models were used to estimate service costs and the likelihood of institutional admission. Patients supported by high integration teams received services costing an estimated 44% more than comparable patients in low integration teams. However, after controlling for case mix, no significant differences were found in the likelihood of admission to mental health inpatient wards or care homes between team types. Integrated mental health and social care teams appeared to facilitate greater access to community care services, but no consequent association was found with community tenure. Further research is required to identify the necessary and sufficient components of integrated community mental health care, and its effect on a wider range of outcomes using patient-reported measures. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.
Stein, Janine; Röhr, Susanne; Luck, Tobias; Löbner, Margrit; Riedel-Heller, Steffi G
2018-01-01
The aim of the study was to investigate the current state of research concerning internationally developed Online Coaches for treatment support and prevention of mental disorders. Evidence and effectiveness of the Online Coaches ought to be explored. A systematic literature search was performed in international databases in order to provide a meta-review of existing Online Coaches for mental disorders. The assessment of the methodological quality and evidence of the studies was based on the established guidelines of the Scottish Intercollegiate Guideline Network. 52 studies (24 meta-analyses, 16 systematic reviews, 2 health-technology assessment reports, and 10 RCT studies) were identified. The efficacy was demonstrated for a variety of Online Coaches for mental disorders, especially for anxiety and depressive disorders, insomnia, and post-traumatic stress disorders, with predominantly acceptable and high quality. The present work provides an overview of internationally developed Online Coaches in the field of mental health care. Online Coaches can serve as a useful supplement to the treatment and prevention of mental disorders. © Georg Thieme Verlag KG Stuttgart · New York.
Experiences of detained young offenders in need of mental health care.
Shelton, Deborah
2004-01-01
To explore the experiences of young people detained in the juvenile justice system and in need of mental health services. An ethnomethodological analysis was done using Kleinman's Explanatory Model Interview Guide to explore the perceptions of detained young people in need of mental health treatment. Five themes were extracted from focus groups, indicating lack of control in their lives and lack of family and community support. Although participants expressed feelings of hopelessness and depression, they perceived that it was better to be tough than to be sick. The findings indicate the need for multimodal treatment interventions to sequentially address the multiple internal and external factors contributing to persistent problem behaviors in children.
Motivation Types and Mental Health of UK Hospitality Workers.
Kotera, Yasuhiro; Adhikari, Prateek; Van Gordon, William
2018-01-01
The primary purposes of this study were to (i) assess levels of different types of work motivation in a sample of UK hospitality workers and make a cross-cultural comparison with Chinese counterparts and (ii) identify how work motivation and shame-based attitudes towards mental health explain the variance in mental health problems in UK hospitality workers. One hundred three UK hospitality workers completed self-report measures, and correlation and multiple regression analyses were conducted to identify significant relationships. Findings demonstrate that internal and external motivation levels were higher in UK versus Chinese hospitality workers. Furthermore, external motivation was more significantly associated with shame and mental health problems compared to internal motivation. Motivation accounted for 34-50% of mental health problems. This is the first study to explore the relationship between motivation, shame, and mental health in UK hospitality workers. Findings suggest that augmenting internal motivation may be a novel means of addressing mental health problems in this worker population.
Kodakandla, Krishna; Nasirabadi, Minhajzafar; Pasha, Mohammed Shahid
2016-08-01
This study aims to assess the intern's beliefs about mental illness, their attitude towards psychiatry and psychiatry as a career choice. In a cross-sectional design, one hundred and seventy six interns from the two medical colleges completed the Belief about Mental illness scale and Attitudes Towards Psychiatry (ATP-29) scale. Majority of the interns considered mentally ill patients as dangerous, unpredictable, cannot take up major responsibilities, cannot be a good parent, have poor interpersonal or social skills. The attitude towards psychiatry overall, functioning of a psychiatrist, efficacy of psychiatry treatment was found to be good in over 90% of the interns. The attitude towards career and reward aspect of psychiatry was not favorable in about 40%. About 13% considered psychiatry as a career choice. Beliefs about mental illness continue to be negative. Though the attitude towards psychiatry, psychiatrist and treatment efficacy is good, the social and reward aspects of psychiatry are not encouraging. Steps for changes in undergraduate medical education policies are required. Copyright © 2016 Elsevier B.V. All rights reserved.
Atri, Ashutosh; Matorin, Anu; Ruiz, Pedro
2011-01-01
the authors investigated whether social support and acculturation could predict the mental health of international medical graduates pursuing psychiatric residencies in the United States. a 55-item online survey was assembled by combining three validated instruments for mental health, social support, and acculturation. A link to the survey was e-mailed to training directors of all psychiatric residency and fellowship programs. Directors were requested to forward the survey to their international medical graduate residents for completion between December 2008 and February 2009. one hundred eight international medical graduates from 70 different psychiatric residencies and fellowships completed the entire survey. Respondents' mental health scores were normally distributed. The vast majority scored very high on survey items related to mental health. Acculturation, social support, and postgraduate training year were significant predictors of mental health. residency training programs should attempt to incorporate measures that would help boost the social support and acculturation of international medical graduates (especially junior-level trainees). Acculturation could be improved by language training and courses in American history, culture, and customs, and social support could be expanded by mentoring relationships.
Puckett, Julia A; Woodward, Eva N; Mereish, Ethan H; Pantalone, David W
2015-09-01
Sexual minority individuals face unique stressors because of their sexual identity. We explored associations between parental reactions to children's coming out, internalized homophobia (IH), social support, and mental health in a sample of 257 sexual minority adults. Path analyses revealed that higher IH and lower social support mediated the association between past parental rejection and current psychological distress. Mental health providers may benefit clients by utilizing interventions that challenge internalized stereotypes about homosexuality, increase social support, and process parental rejection, as well as focusing on how certain crucial experiences of rejection may impact clients' IH and mental health.
Betancourt, Theresa S.; McBain, Ryan; Newnham, Elizabeth A.; Brennan, Robert T.
2013-01-01
Background Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics—social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth—in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in post-conflict Sierra Leone. Methods 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. Results Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively co-varied with youths’ externalizing and internalizing scores—indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p<0.05). The relationship between collective efficacy and mental health outcomes was non-significant (p>0.05). Conclusions This study offers a rare glimpse into the role that the post-conflict social context plays in shaping mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a four-year period of follow up. These results underscore the importance of the post-conflict social environment and the need to develop post-conflict interventions that address community-level processes in addition to the needs of the individual. PMID:24102324
Cunico, Laura; Fredo, Susanna; Bernini, Massimo
2017-01-01
The review aimed to identify and analyse the future development on the topic by analysing the main themes discussed in number of scientific journal focused on Mental Health both by nurses and physicians.. 4 international journals focused on Mental health and psychiatry International Journal of Mental Health Nursing, Archives of Psychiatric Nursing, American Journal of Psychiatry, Australian and New Zeland Journal of Psychiatry as well as two journal focused generically on health, Journal of Advanced Nursing and Lancet were scrutinized. We have analysed the papers of 2012-2015 for the specialised journals and last and first 6 months of 2012 and 2013 and 2014-2015 for the generic. Editorials, comments and contributions regarding theoretical models were exluded. From the analysis we identified 9 themes and for each theme the pertinent category. For the diagnostic grouping we used the International Statistical Classification of Diseases and Related Health Problems 10th Revision. A trend in research about mood disorders, schizophrenia and addictions and comorbidity emerged according to the 2099 abstracts analysed. Within medical research antidepressants were the most studied psychotropic medication and cognitive behaviour therapy was the most studied psychotherapy. Within nursing research: the nurse-patient relationship, adherence and monitoring of pharmacological therapy, the treatment planning and the working environment, the nursing training and its efficacy. The clinical research trials were twice as frequent in the medical versus nursing research where qualitative research prevails. The research challenge will be to find a new paradigm fit for the future psychiatry having at its disposition the patient's genoma, and needing to routinely use biomarkers for a personalised therapy. A further challenge might be the promotion of interprofessional research between doctors and nurses and the acquisition of new competences of health professionals needed to tackle the reduced life expectancy of psychiatric patients and to address not only their mental illnesses but also their physical ailments.
Dixon, Jeremy; Lei, Jie; Huang, Wanyi; Sin, Jacqueline; Smith, Gina
2018-02-21
Family Interventions in Psychosis (FIP) have been promoted internationally but have been criticised for being based on western cultural models. This paper reports on a focus group study with 10 Integrated Mental Health Service Managers in Guangzhou, China using thematic analysis. Managers believed FIP might benefit families but identified potential difficulties due to (a) families avoiding services due to the 'shame' of mental illness (b) unrealistic expectations of services amongst families (c) deferral to 'key decision-makers' within families when discussing family issues with workers. The findings indicate that FIP work should focus on interaction between carers in the first instance with service users being introduced into sessions at a later date and that more attention needs to be given by the research community to how FIP may be adapted to cultural norms within China.
de Menil, V; Knapp, M; McDaid, D; Raja, S; Kingori, J; Waruguru, M; Wood, S K; Mannarath, S; Lund, C
2015-10-01
The treatment gap for serious mental disorders across low-income countries is estimated to be 89%. The model for Mental Health and Development (MHD) offers community-based care for people with mental disorders in 11 low- and middle-income countries. In Kenya, using a pre-post design, 117 consecutively enrolled participants with schizophrenia-spectrum and bipolar disorders were followed-up at 10 and 20 months. Comparison outcomes were drawn from the literature. Costs were analysed from societal and health system perspectives. From the societal perspective, MHD cost Int$ 594 per person in the first year and Int$ 876 over 2 years. The cost per healthy day gained was Int$ 7.96 in the first year and Int$ 1.03 over 2 years - less than the agricultural minimum wage. The cost per disability-adjusted life year averted over 2 years was Int$ 13.1 and Int$ 727 from the societal and health system perspectives, respectively, on par with antiretrovirals for HIV. MHD achieved increasing returns over time. The model appears cost-effective and equitable, especially over 2 years. Its affordability relies on multi-sectoral participation nationally and internationally.
Brandstetter, Susanne; Dodoo-Schittko, Frank; Speerforck, Sven; Apfelbacher, Christian; Grabe, Hans-Jörgen; Jacobi, Frank; Hapke, Ulfert; Schomerus, Georg; Baumeister, Sebastian E
2017-08-01
This study sought to examine trends in non-help-seeking for mental disorders among persons with a prevalent mental disorder (12-month prevalence) in Germany between 1997-1999 and 2009-2012. We examined data from 1909 persons aged 18-65 years who participated in two independent, repeated cross-sectional surveys (German National Interview and Examination Study 1997-1999, German Health Interview and Examination Survey for Adults 2009-2012) conducted 12 years apart. Prevalent mental disorders (12-month prevalence) were determined using the Composite International Diagnostic Interview, which included information on lifetime help-seeking for mental health problems. Correlates of self-reported help-seeking were analyzed according to Andersen's Behavioral Model. Multivariable Poisson regression models were used to assess time trends in the directly standardized and model-adjusted prevalence of non-help-seeking across strata of socio-economic and clinical variables. The proportion of people with a prevalent mental disorder who have never sought help in their lifetime decreased significantly from 62% (95% CI 58.7-64.7) to 57% (95% CI 52.2-60.9) between 1997-1999 and 2009-2012 in adults aged 18-65 years in Germany. Downward trends in non-help-seeking occurred in all investigated strata and reached statistical significance in women, in people who were living alone, people with medium educational level, people living in middle-sized communities, people with non-statutory health insurance, smokers, and people with co-existing somatic conditions. Despite a downward trend over the course of 12 years, a large proportion of people suffering from mental disorders are still not seeking treatment in Germany. Further efforts to increase uptake of help-seeking for mental disorders in hard-to-reach groups are warranted to continue this trend.
Pachankis, John E; Rendina, H Jonathon; Restar, Arjee; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T
2015-08-01
Sexual compulsivity represents a significant public health concern among gay and bisexual men, given its co-occurrence with other mental health problems and HIV infection. The purpose of this study was to examine a model of sexual compulsivity based on minority stress theory and emotion regulation models of mental health among gay and bisexual men. Gay and bisexual men in New York City reporting at least nine past-90-day sexual partners (n = 374) completed measures of distal minority stressors (i.e., boyhood gender nonconformity and peer rejection, adulthood perceived discrimination), hypothesized proximal minority stress mediators (i.e., rejection sensitivity, internalized homonegativity), hypothesized universal mediators (i.e., emotion dysregulation, depression, and anxiety), and sexual compulsivity. The hypothesized model fit the data well (RMSEA = 0.05, CFI = 0.98, TLI = 0.95, SRMR = 0.03). Distal minority stress processes (e.g., adulthood discrimination) were generally found to confer risk for both proximal minority stressors (e.g., internalized homonegativity) and emotion dysregulation. Proximal minority stressors and emotion dysregulation, in turn, generally predicted sexual compulsivity both directly and indirectly through anxiety and depression. The final model suggests that gay-specific (e.g., internalized homonegativity) and universal (e.g., emotion dysregulation) processes represent potential treatment targets to attenuate the impact of minority stress on gay and bisexual men's sexual health. Tests of interventions that address these targets to treat sexual compulsivity among gay and bisexual men represent a promising future research endeavor. (c) 2015 APA, all rights reserved).
Pachankis, John E.; Rendina, H. Jonathon; Restar, Arjee; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T.
2014-01-01
Objective Sexual compulsivity represents a significant public health concern among gay and bisexual men given its co-occurrence with other mental health problems and HIV infection. The purpose of this study was to examine a model of sexual compulsivity based on minority stress theory and emotion regulation models of mental health among gay and bisexual men. Method Gay and bisexual men in New York City reporting at least nine past-90-day sexual partners (n = 374) completed measures of distal minority stressors (i.e., boyhood gender nonconformity and peer rejection, adulthood perceived discrimination), hypothesized proximal minority stress mediators (i.e., rejection sensitivity, internalized homonegativity), hypothesized universal mediators (i.e., emotion dysregulation, depression and anxiety), and sexual compulsivity. Results The hypothesized model fit the data well (RMSEA = 0.05, CFI = 0.98, TLI = 0.95, SRMR = 0.03). Distal minority stress processes (e.g., peer rejection) were generally found to confer risk for both proximal minority stressors (e.g., internalized homonegativity) and emotion dysregulation. Proximal minority stressors and emotion dysregulation, in turn, generally predicted sexual compulsivity both directly and indirectly through anxiety and depression. Conclusions The final model suggests that gay-specific (e.g., internalized homonegativity) and universal (e.g., emotion dysregulation) processes represent potential treatment targets to attenuate the impact of minority stress on gay and bisexual men's sexual health. Tests of interventions that address these targets to treat sexual compulsivity among gay and bisexual men represent a promising future research endeavor. PMID:25528179
Lupano Perugini, María Laura; de la Iglesia, Guadalupe; Castro Solano, Alejandro; Keyes, Corey Lee M.
2017-01-01
The present research aimed at studying the psychometric properties of the Mental Health Continuum–Short Form (MHC–SF; Keyes, 2005) in a sample of 1,300 Argentinean adults (50% males; 50% females). Their mean age was 40.28 years old (SD = 13.59). The MHC–SF is a 14 item test that assesses three components (i.e., emotional, social, and psychological) of well-being. Convergent and divergent evidence of construct validity was assessed by conducting confirmatory factor analysis, cross-validation, factorial invariance, and correlations with external criteria. Internal consistency was studied using Cronbach’s alphas. Results indicated an adequate fit of a three-dimensional model. This structure was also confirmed, and was invariant throughout sex and age. The emotional well-being scores converged with life satisfaction and positive affect measures; the psychological well-being scale had a positive association with the presence of meaning in life; and the social well-being scores showed a positive and strong correlation with an external measure of well-being. Also, all scores were negatively associated with negative affect, search of meaning in life, and presence of depression symptoms. Internal consistency was .89 for the MHC–SF. Furthermore, the findings supported the two - continua model of mental health. PMID:28344677
Sharma, Manasi; Fine, Shoshanna L; Brennan, Robert T; Betancourt, Theresa S
2017-02-01
This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10-17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.
Sandfort, Theo; Bos, Henny; Knox, Justin; Reddy, Vasu
2015-01-01
Using data from a study about HIV risk among Black South African MSM, we aimed to ascertain whether unexpected findings about the relationship between gender nonconformity, discrimination, and mental health in this population, as reported by Cook, Sandfort, Nel, and Rich (2013), could be replicated, and to explore more in-depth how gender nonconformity relates to health. Cook et al. found that feminine men were not more likely to be depressed despite the observation that they were more likely to be discriminated against and that discrimination increased the likelihood of depression. This is in contrast to what studies among gay and bisexual men in Western countries have consistently shown. In the current study, 196 Black South African MSM (ages between 18 and 40; mean age, 26.65 years) were surveyed. Assessments included stressors (identity confusion, internalized homophobia, and sexual orientation-based discrimination) and resilience factors (openness about one’s sexual orientation, social support, and identification with the gay community). We observed that gender-nonconforming men were not more likely to be depressed despite having experienced more discrimination, which was associated with depression. The same relationships were observed when considering anxiety as the mental health outcome. We found an indirect negative effect of gender nonconformity on depression through internalized homophobia, suggesting that, in this population, internalized homophobia masks the effect of discrimination on mental distress. Implications for the sexual minority stress model, used to guide our analyses, are discussed. Further research is needed to entangle the complex relationship between gender nonconformity and mental health among MSM populations. PMID:26067298
A life course perspective on mental health problems, employment, and work outcomes.
Veldman, Karin; Reijneveld, Sijmen A; Verhulst, Frank C; Ortiz, Josue Almansa; Bültmann, Ute
2017-07-01
Objectives Little is known about how employment and work outcomes among young adults are influenced by their life-course history of mental health problems. Therefore, the aims of this study were to (i) identify trajectories of mental health problems from childhood to young adulthood and (ii) investigate the association between these trajectories and employment and work outcomes among young adults. Methods Data were used from 360 participants of the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study, with 12-year follow-up. Trajectories of externalizing and internalizing problems were identified with latent class growth models. Employment conditions and work outcomes (ie, psychosocial work characteristics) were measured at age 22. We assessed the association between mental health trajectories and employment conditions and work outcomes. Results Four trajectories of mental health problems were identified: high-stable, decreasing, moderate-stable and low-stable. Young adults with high-stable trajectories of externalizing problems worked over six hours more [B=6.71, 95% confidence interval (95% CI) 2.82-10.6] and had a higher income [odds ratio (OR) 0.33, 95% CI 0.15-0.71], than young adults with low-stable trajectories. Young adults with high-stable trajectories of internalizing problems worked six hours less per week (B=-6.07, 95% CI -10.1- -2.05) and reported lower income (OR 3.44, 95% CI 1.53-7.74) and poorer psychosocial work characteristics, compared to young adults with low-stable trajectories. Conclusions Among young adults who had a paid job at the age of 22 (and were not a student or unemployed), those with a history of internalizing problems are less likely to transition successfully into the labor market, compared to other young adults.
Joly, Laurène
Objectives The aim of this article is to present an overview of the reflections led by various European and international organizations on the employment of people with mental disorders.Methods This study is based on data from websites of international organizations and interviews taken place with a disability specialist at the International Labour Organisation (ILO) and members of the European Commission.Results Unlike the French law of 11 February 2005 which refers expressly to psychic disability, this notion is not explicitly dedicated by various European and international legal rules. However, these standards like the United Nations Convention on the Rights of Persons with Disabilities have adopted the contemporary model which presents disability as the result of an interaction between person and environment. Thus they acknowledge that disabled people include people suffering from mental disorders because in the person's environment, a psychiatric impairment could lead to limitations of activities or restrictions of social participation that constitute a situation of disability of psychiatric origin. Therefore, the legal mechanisms often do not provide appropriate answers to the characteristics of psychiatric disability.Besides, negative attitudes, stereotypes and discrimination towards people with a psychiatric disability are still observed in the workplace, in spite of intensified anti-discrimination legislation.This study inventories the different proposals to remedy to substantial barriers to the employment of people with a psychiatric condition. In the European Union's strategy for increasing the employment of these persons, particular consideration is given to put forward a series of key recommendations to improve practices of reasonable accommodation in the workplace. Nonetheless, it must be emphasized that it is necessary to conceive adequate measures in order to take into account the changeability and the unpredictability of mental disorders. Indeed, situations of psychiatric disability require flexibility and reactivity more than any other situation of disability. The discrimination experienced by people with a psychiatric disability is likely to continue as long as specific responses are not implemented. In this perspective, ILO highlights a number of best practices addressing the challenges of psychiatric disabled people's employment. That is why a disability network was created to share knowledge. The great added value of this network is the opportunity to share best practices between companies, best practices between countries in order to increase the ability to include people with mental disorders. Focus is put on strategies to combat discrimination in employment, by raising awareness, exploring measures and good practices to improve mental health in the workplace.Conclusion Finally, this study shows similar challenges in the prevention of the mental health and the issue of the psychiatric handicap, including to remedy to the insufficient attention paid to provide reasonable accommodation to persons with mental disorders.
The stigma of mental health problems in the military.
Greene-Shortridge, Tiffany M; Britt, Thomas W; Castro, Carl Andrew
2007-02-01
The present review addresses the perceived stigma associated with admitting a mental health problem and seeking help for that problem in the military. Evidence regarding the public stigma associated with mental disorders is reviewed, indicating that the public generally holds negative stereotypes toward individuals with psychological problems, leading to potential discrimination toward these individuals. The internalization of these negative beliefs results in self-stigma, leading to reduced self-esteem and motivation to seek help. Even if soldiers form an intention to seek help for their psychological difficulty, barriers to mental health care may prevent the soldier from receiving the help they need. An overall model is proposed to illustrate how the stigma associated with psychological problems can prevent soldiers getting needed help for psychological difficulties and proposed interventions for reducing stigma in a civilian context are considered for military personnel.
Model for investigating the benefits of clinical supervision in psychiatric nursing: a survey study.
Gonge, Henrik; Buus, Niels
2011-04-01
The objective of this study was to test a model for analysing the possible benefits of clinical supervision. The model suggested a pathway from participation to effectiveness to benefits of clinical supervision, and included possible influences of individual and workplace factors. The study sample was 136 nursing staff members in permanent employment on nine general psychiatric wards and at four community mental health centres at a Danish psychiatric university hospital. Data were collected by means of a set of questionnaires. Participation in clinical supervision was associated with the effectiveness of clinical supervision, as measured by the Manchester Clinical Supervision Scale (MCSS). Furthermore, MCSS scores were associated with benefits, such as increased job satisfaction, vitality, rational coping and less stress, emotional exhaustion, and depersonalization. Multivariate analyses indicated that certain individual and workplace factors were related to subscales of the MCSS, as well as some of the benefits. The study supported the suggested model, but methodological limitations apply. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Mental Health Need, Awareness, and Use of Counseling Services among International Graduate Students
ERIC Educational Resources Information Center
Hyun, Jenny; Quinn, Brian; Madon, Temina; Lustig, Steve
2007-01-01
Objective and Participants: The authors examined the prevalence of mental health needs in international graduate students, their knowledge of mental health services, and their use of on-campus and off-campus counseling services. Methods: All registered graduate students in the Spring 2004 semester received an e-mail invitation to participate in a…
Rainville, G
2017-09-13
The interrelation of worship service attendance and private prayer in moderating the negative impact of life event stressors on mental well-being is examined using hierarchical multiple regressions on a national sample of 2601 Americans. A theoretical model is proposed in which stressful life events are made less distressing under conditions in which exposure to pro-social content at worship services is internalized through frequent private prayer. Interactive models controlling for a block of potential confounds are run to confirm that the stress-moderating effects of worship service attendance are noted only when attendance is complemented by relatively frequent engagement in private prayer.
Mental Health Education in Three Primary Care Specialities.
ERIC Educational Resources Information Center
Strain, James J.; And Others
1986-01-01
The characteristics of the mental health components of residency training in traditional internal medicine, primary care internal medicine, and family practice were examined. Internal medicine programs relied on the consultation method and in-patient facilities, and used the psychiatrist as the primary teacher. Evaluation of the outcome of…
Development of Translation Materials to Assess International Students' Mental Health Concerns
ERIC Educational Resources Information Center
Chalungsooth, Pornthip; Schneller, Gregory R.
2011-01-01
International college students in the United States often face adjustment difficulties; therefore, cultural sensitivity is necessary to help them express their concerns. This article describes the development of translations of international students' common mental health concerns into 7 languages. Suggestions for the use of translated materials…
Mental health and addictions capacity building for community health centres in Ontario.
Khenti, Akwatu; Thomas, Fiona C; Mohamoud, Sirad; Diaz, Pablo; Vaccarino, Oriana; Dunbar, Kate; Sapag, Jaime C
2017-10-01
In recent years, there has been increased recognition in Canada of the need to strengthen mental health services in primary health care (PHC). Collaborative models, including partnerships between PHC and specialized mental health care providers, have emerged as effective ways for improving access to mental health care and strengthening clinical capacity. Primary health care physicians and other health professionals are well positioned to facilitate the early detection of mental disorders and provide appropriate treatment and follow-up care, helping to tackle stigma toward mental health problems in the process. This 4-year mental health and addiction capacity-building initiative for PHC addressed competency needs at the individual, interprofessional, and organizational levels. The program included 5 key components: a needs assessment; interprofessional education; mentoring; development of organizational mental health and addiction action plans for each participating community health centre; and creation of an advanced resource manual to support holistic and culturally competent collaborative mental health care. A comprehensive evaluation framework using a mixed-methods approach was applied from the initiation of the program. A total of 184 health workers in 10 community health centres in Ontario participated in the program, including physicians, nurses, social workers, and administrative staff. Evaluation findings demonstrated high satisfaction with the training, improved competencies, and individual behavioural and organizational changes. By building capacity to integrate holistic and culturally appropriate care, this competency-based program is a promising model with strong potential to be adapted and scaled up for PHC organizations nationally and internationally. Copyright© the College of Family Physicians of Canada.
Behrendt, Silke; Bühringer, Gerhard; Höfler, Michael; Lieb, Roselind; Beesdo-Baum, Katja
2017-10-01
Comorbid internalizing mental disorders in alcohol use disorders (AUD) can be understood as putative independent risk factors for AUD or as expressions of underlying shared psychopathology vulnerabilities. However, it remains unclear whether: 1) specific latent internalizing psychopathology risk-profiles predict AUD-incidence and 2) specific latent internalizing comorbidity-profiles in AUD predict AUD-stability. To investigate baseline latent internalizing psychopathology risk profiles as predictors of subsequent AUD-incidence and -stability in adolescents and young adults. Data from the prospective-longitudinal EDSP study (baseline age 14-24 years) were used. The study-design included up to three follow-up assessments in up to ten years. DSM-IV mental disorders were assessed with the DIA-X/M-CIDI. To investigate risk-profiles and their associations with AUD-outcomes, latent class analysis with auxiliary outcome variables was applied. AUD-incidence: a 4-class model (N=1683) was identified (classes: normative-male [45.9%], normative-female [44.2%], internalizing [5.3%], nicotine dependence [4.5%]). Compared to the normative-female class, all other classes were associated with a higher risk of subsequent incident alcohol dependence (p<0.05). AUD-stability: a 3-class model (N=1940) was identified with only one class (11.6%) with high probabilities for baseline AUD. This class was further characterized by elevated substance use disorder (SUD) probabilities and predicted any subsequent AUD (OR 8.5, 95% CI 5.4-13.3). An internalizing vulnerability may constitute a pathway to AUD incidence in adolescence and young adulthood. In contrast, no indication for a role of internalizing comorbidity profiles in AUD-stability was found, which may indicate a limited importance of such profiles - in contrast to SUD-related profiles - in AUD stability. Copyright © 2017 Elsevier B.V. All rights reserved.
Pakistan mental health country profile.
Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel
2004-01-01
The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.
Diet quality and mental health in subsequent years among Canadian youth.
McMartin, Seanna E; Kuhle, Stefan; Colman, Ian; Kirk, Sara F L; Veugelers, Paul J
2012-12-01
To examine the association between diet quality and the diagnosis of an internalizing disorder in children and adolescents. A prospective study examining the relationship between diet quality and mental health. FFQ responses of 3757 children were used to calculate a composite score for diet quality and its four components: variety, adequacy, moderation and balance. Physicians' diagnoses on internalizing disorders were obtained by linking the children's dietary information to administrative health data. Negative binomial regression models were used to examine the association between diet quality and diagnosis of an internalizing disorder. The Canadian province of Nova Scotia. A provincially representative sample of grade 5 students (age 10-11 years). Diet quality was not found to be associated with internalizing disorder in a statistically significant manner (incidence rate ratio = 1.09; 95 % CI 0.73, 1.63). However, relative to children with little variety in their diets, children with greater variety in their diet had statistically significant lower rates of internalizing disorder in subsequent years (incidence rate ratio = 0.45; 95 % CI 0.25, 0.82). These findings suggest the importance of variety in children's diet and opportunities in the prevention of adolescent depression and anxiety.
Burns, Jonathan Kenneth
2009-01-01
Mental disability and mental health care have been neglected in the discourse around health, human rights, and equality. This is perplexing as mental disabilities are pervasive, affecting approximately 8% of the world population. Furthermore, the experience of persons with mental disability is one characterized by multiple interlinked levels of inequality and discrimination within society. Efforts directed toward achieving formal equality should not stand alone without similar efforts to achieve substantive equality for persons with mental disabilities. Structural factors such as poverty, inequality, homelessness, and discrimination contribute to risk for mental disability and impact negatively on the course and outcome of such disabilities. A human rights approach to mental disability means affirming the full personhood of those with mental disabilities by respecting their inherent dignity, their individual autonomy and independence, and their freedom to make their own choices. A rights-based approach requires us to examine and transform the language, terminology, and models of mental disability that have previously prevailed especially within health discourse. Such an approach also requires us to examine the multiple ways in which inequality and discrimination characterize the lives of persons with mental disabilities and to formulate a response based on a human rights framework. In this article, I examine issues of terminology, models of understanding mental disability, and the implications of international treaties such as the United Nations Convention on the Rights of Persons with Disabilities for our response to the inequalities and discrimination that exist within society--both within and outside the health care system. Finally, while acknowledging that health care professionals have a role to play as advocates for equality, non-discrimination, and justice, I argue that it is persons with mental disabilities themselves who have the right to exercise agency in their own lives and who, consequently, should be at the center of advocacy movements and the setting of the advocacy agenda.
When energy saving advice leads to more, rather than less, consumption
NASA Astrophysics Data System (ADS)
Revell, Kirsten M. A.; Stanton, Neville A.
2017-01-01
Energy saving technology that relies on behaviour change fails to deliver on its promise. Energy saving advice also has limited effect. This paper examines and reveals how technology and energy saving advice interacts with householders' thought processes to influence energy consumption. A case study of three households that held a 'Feedback' mental model of the home heating thermostat, as defined by Kempton [1986. 'Two Theories of Home Heat Control'. Cognitive Science 10 (1): 75-90], was undertaken to understand the driver behind differences in their home heating strategies, and the effect on energy consumption. Analysis was undertaken from five different data sources comprising: (1) boiler on durations, (2) thermostat set point adjustments, (3) self-reported strategies with home heating controls, (4) user mental model descriptions of the home heating system, and (5) Interview transcripts. The authors found that differences in user mental models of home heating at the system level explained differences in the strategies chosen at the control device level. Differences in boiler on periods were found to relate to limitations of the 'Feedback' mental model; that is, the model fails to consider the effect of the movement of warm air within the home and the impact of internal/external temperature differentials on heat loss rates. The authors argue that technology and advice should be tailored to the thought processes adopted by householders in order to promote behaviour that would realise intended energy savings.
Stigma and social support in substance abuse: Implications for mental health and well-being.
Birtel, Michèle D; Wood, Lisa; Kempa, Nancy J
2017-06-01
Individuals with substance abuse may suffer from severe public and internalized stigma. Little is known about how social support can reduce stigma and improve mental health and well-being for them. This research examined how perceived stigma influences individuals in treatment for substance abuse, and whether internalized stigma and shame are mechanisms which link social support with better mental health and well-being. Sixty-four participants in treatment for substance abuse (alcohol, drugs), aged between 18 and 64, completed an online survey measuring perceived stigma, internalized stigma, shame, perceived social support, and mental health and well-being (self-esteem, depression and anxiety, sleep). We found that perceived stigma was associated with lower self-esteem, higher depression and anxiety, and poorer sleep. Furthermore, perceived social support followed the opposite pattern, and was associated with higher self-esteem, lower depression and anxiety, and better sleep. The effects of perceived stigma and of perceived social support on our outcome measures were mediated by internalized stigma and by internalized shame. Helping individuals with substance abuse to utilize their social support may be fruitful for combatting the negative impact of internalized stigma and shame on mental health and well-being. Copyright © 2017. Published by Elsevier B.V.
Gøtzsche-Astrup, Oluf; Moskowitz, Andrew
2016-02-01
The aim of this study was to review and discuss the evidence for dimensional classification of personality disorders and the historical and sociological bases of psychiatric nosology and research. Categorical and dimensional conceptualisations of personality disorder are reviewed, with a focus on the Diagnostic and Statistical Manual of Mental Disorders-system's categorisation and the Five-Factor Model of personality. This frames the events leading up to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, personality disorder debacle, where the implementation of a hybrid model was blocked in a last-minute intervention by the American Psychiatric Association Board of Trustees. Explanations for these events are discussed, including the existence of invisible colleges of researchers and the fear of risking a 'scientific revolution' in psychiatry. A failure to recognise extra-scientific factors at work in classification of mental illness can have a profound and long-lasting influence on psychiatric nosology. In the end it was not scientific factors that led to the failure of the hybrid model of personality disorders, but opposing forces within the mental health community in general and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Task Force in particular. Substantial evidence has accrued over the past decades in support of a dimensional model of personality disorders. The events surrounding the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Personality and Personality Disorders Work Group show the difficulties in reconciling two different worldviews with a hybrid model. They also indicate the future of a psychiatric nosology that will be increasingly concerned with dimensional classification of mental illness. As such, the road is paved for more substantial changes to personality disorder classification in the International Classification of Diseases, 11th Revision, in 2017. © The Royal Australian and New Zealand College of Psychiatrists 2015.
PERSPECTIVES: Accountability for Mental Health: The Australian Experience.
Rosenberg, Sebastian; Salvador-Carulla, Luis
2017-03-01
Australia was one of the first countries to develop a national policy for mental health. A persistent characteristic of all these policies has been their reference to the importance of accountability. What does this mean exactly and have we achieved it? Can Australia tell if anybody is getting better? To review accountability for mental health in Australia and question whether two decades of Australian rhetoric around accountability for mental health has been fulfilled. This paper first considers the concept of accountability and its application to mental health. We then draw on existing literature, reports, and empirical data from national and state governments to illustrate historical and current approaches to accountability for mental health. We provide a content analysis of the most current set of national indicators. The paper also briefly considers some relevant international processes to compare Australia's progress in establishing accountability for mental health. Australia's federated system of government permits competing approaches to accountability, with multiple and overlapping data sets. A clear national approach to accountability for mental health has failed to emerge. Existing data focuses on administrative and health service indicators, failing to reflect broader social factors which reveal quality of life. In spite of twenty years of investment and effort Australia has been described as outcome blind, unable to demonstrate the merit of USD 8bn spent on mental health annually. While it may be prolific, existing administrative data provide little outcomes information against which Australia can genuinely assess the health and welfare of people with a mental illness. International efforts are evolving slowly. Even in high income countries such as Australia, resources for mental health services are constrained. Countries cannot afford to continue to invest in services or programs that fail to demonstrate good outcomes for people with a mental illness or are not value for money. New approaches are needed which ensure that chosen accountability indicators reflect national health and social priorities. Such priorities must be meaningful to a range of stakeholders and the community about the state of mental health. They must drive an agenda of continuous improvement relevant to those most affected by mental disorders. These approaches should be operable in emerging international contexts. Australia must further develop its approach to health accountability in relation to mental health. A limited set of new preferred national mental health indicators should be agreed. These should be tested, both domestically and internationally, for their capacity to inform and drive quality improvement processes in mental health. Existing systems of accountability are not fit for purpose, incapable of firing necessary quality improvement processes. Supported by adequate resources, realistic targets and a culture of openness, new accountability could drive real quality improvement processes for mental health, facilitate jurisdictional comparisons in Australia, and contribute to new efforts to benchmark mental health internationally.
Edwards-Stewart, Amanda; Ahmad, Zeba S; Thoburn, John W; Furman, Rich; Lambert, Ashly J; Shelly, Lauren; Gunn, Ginger
2012-01-01
The current article introduces Embedded Indigenous Psychological Support Teams (IPST) as a possible addition to current disaster relief efforts. This article highlights psychological first aid in an international context by drawing on mainstream disaster relief models such as The American Red Cross, Critical Incident Stress Management, and Flexible Psychological First Aid. IPST are explained as teams utilizing techniques from both CISM and FPFA with a focus on resiliency. It is currently theorized that in utilizing IPST existing disaster relief models may be more effective in mitigating negative physical or mental health consequences post-disaster.
Cain, Demetria N; Mirzayi, Chloe; Rendina, H Jonathon; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T
2017-10-01
Depression negatively impacts the health and well-being of gay and bisexual men (GBM). However, little is known about the contexts in which rural GBM live relative to those living in urban areas and their overall mental health. The aim of this study was to examine associations between population density and depressive symptoms and the role of internalized homonegativity and social support as potential mediators. A nationally representative sample of 1071 GBM (mean age = 40.24) was enrolled. Participants provided their zip codes, which were categorized according to population density and rank-normalized. In a path analysis model adjusted for race/ethnicity, college education, age, and relationship status, higher population density was significantly associated with increased social support (B = 0.11, P = 0.002) and decreased internalized homonegativity (B = -0.06, P < 0.001). In turn, lower social support (B = -2.93, P < 0.001) and greater internalized homonegativity (B = 4.93, P < 0.001) were significantly associated with greater depressive symptoms. The indirect effects of population density on depression through social support (B = -0.33, P < 0.001) and internalized homonegativity (B = -0.31, P < 0.001) were statistically significant, suggesting evidence for mediation of the effects. These results indicate that living in less inhabited areas acts on depressive symptoms through mechanisms of lower social support and higher internalized homonegativity. These findings suggest that social contexts in which GBM live can affect mental health outcomes and indicate the need for further support and inclusion of GBM, especially in less inhabited areas.
Cain, Demetria N.; Mirzayi, Chloe; Rendina, H. Jonathon; Ventuneac, Ana; Grov, Christian
2017-01-01
Abstract Purpose: Depression negatively impacts the health and well-being of gay and bisexual men (GBM). However, little is known about the contexts in which rural GBM live relative to those living in urban areas and their overall mental health. The aim of this study was to examine associations between population density and depressive symptoms and the role of internalized homonegativity and social support as potential mediators. Methods: A nationally representative sample of 1071 GBM (mean age = 40.24) was enrolled. Participants provided their zip codes, which were categorized according to population density and rank-normalized. Results: In a path analysis model adjusted for race/ethnicity, college education, age, and relationship status, higher population density was significantly associated with increased social support (B = 0.11, P = 0.002) and decreased internalized homonegativity (B = −0.06, P < 0.001). In turn, lower social support (B = −2.93, P < 0.001) and greater internalized homonegativity (B = 4.93, P < 0.001) were significantly associated with greater depressive symptoms. The indirect effects of population density on depression through social support (B = −0.33, P < 0.001) and internalized homonegativity (B = −0.31, P < 0.001) were statistically significant, suggesting evidence for mediation of the effects. Conclusions: These results indicate that living in less inhabited areas acts on depressive symptoms through mechanisms of lower social support and higher internalized homonegativity. These findings suggest that social contexts in which GBM live can affect mental health outcomes and indicate the need for further support and inclusion of GBM, especially in less inhabited areas. PMID:28792886
An Exploration of Secondary Students' Mental States When Learning about Acids and Bases
ERIC Educational Resources Information Center
Liu, Chia-Ju; Hou, I-Lin; Chiu, Houn-Lin; Treagust, David F.
2014-01-01
This study explored factors of students' mental states, including emotion, intention, internal mental representation, and external mental representation, which can affect their learning performance. In evaluating students' mental states during the science learning process and the relationship between mental states and learning…
2013-01-01
Background Former studies have shown increased mental health problems in adolescents after parental divorce all over the Western world. We wanted to see if that still is the case in Norway today when divorce turns to be more and more common. Methods In a prospective study design, two samples were constituted, adolescents at a baseline survey in 2001/02 (n = 2422) and those at follow-up in 2003/04 (n = 1861), when the adolescents were 15/16 and 18/19 years-old, respectively. They answered self-administered questionnaires in both surveys of Young-HUBRO in Oslo. Early parental divorce was defined as that which occured before age 15/16 years, and late divorce occured between age 15/16 and 18/19. Internalized and externalized mental health problems were measured by the Hopkin’s Symptom Check List (HSCL-10) and the Strengths and Difficulties Questionnaire (SDQ). Results After linear regression models were adjusted for gender, ethnicity, family economy, social support, and mental health problem symptoms measured at baseline before parental divorce occured, late parental divorce did not lead to significant increase in mental health problems among adolescents in the city of Oslo. Early parental divorce was associated with internal mental health problems among young adolescents when adjusted only for the first four possible confounders. Conclusions It seems that parental divorce in late adolescence does not lead to mental health problems in Norway any more, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce create less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common. PMID:23631712
Discrimination, Perceived Social Inequity, and Mental Health Among Rural-to-Urban Migrants in China
Lin, Danhua; Wang, Bo; Hong, Yan; Qin, Xiong; Stanton, Bonita
2010-01-01
Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004–2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being. PMID:20033772
Zeratsion, Henok; Dalsklev, Madeleine; Bjertness, Espen; Lien, Lars; Haavet, Ole R; Halvorsen, Jon A; Bjertness, Cecilie B; Claussen, Bjørgulf
2013-04-30
Former studies have shown increased mental health problems in adolescents after parental divorce all over the Western world. We wanted to see if that still is the case in Norway today when divorce turns to be more and more common. In a prospective study design, two samples were constituted, adolescents at a baseline survey in 2001/02 (n = 2422) and those at follow-up in 2003/04 (n = 1861), when the adolescents were 15/16 and 18/19 years-old, respectively. They answered self-administered questionnaires in both surveys of Young-HUBRO in Oslo. Early parental divorce was defined as that which occured before age 15/16 years, and late divorce occured between age 15/16 and 18/19. Internalized and externalized mental health problems were measured by the Hopkin's Symptom Check List (HSCL-10) and the Strengths and Difficulties Questionnaire (SDQ). After linear regression models were adjusted for gender, ethnicity, family economy, social support, and mental health problem symptoms measured at baseline before parental divorce occured, late parental divorce did not lead to significant increase in mental health problems among adolescents in the city of Oslo. Early parental divorce was associated with internal mental health problems among young adolescents when adjusted only for the first four possible confounders. It seems that parental divorce in late adolescence does not lead to mental health problems in Norway any more, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce create less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common.
Lien, Lars
2008-06-01
The aim of this study was to describe the prevalence of and investigate the association between mental health problems, asthma, allergy and eczema in Norwegian and immigrant youths. A cross-sectional study was performed of all 10th-grade students in Oslo, Norway, in two school years; 1999-2000 and 2000-2001. Of the 8316 eligible students, 7345 (88.3%) participated. Internalized mental problems were measured using the Hopkins Symptom Check List 10-version, and two subscales of the Strength and Difficulties Questionnaire were used to study externalizing mental health problems. All questions are based on self-report, and 25% of the sample had an immigrant background. Immigrant boys had higher scores on internalizing problems than Norwegian boys. First-generation immigrants reported less asthma and eczema than Norwegians. The strongest association between mental health problems and inflammatory conditions was for allergy and internalizing problems for boys (odds ratio (OR)=2.5 for immigrants and OR=1.8 for Norwegians). For girls, it was allergy in Norwegians (OR=1.6) and asthma for immigrants (OR=2.2). For externalizing problems, the association was strongest for asthma in boys and eczema in girls. Immigrant boys had stronger associations between number of inflammatory conditions and internalizing mental health problems than Norwegians (OR=3.2 vs. OR=2.4). Among girls, the figures were 1.7 for Norwegians and 1.8 for immigrants. There is a strong association between number of inflammatory conditions and internalizing mental health problems, especially among boys with an immigrant background. The association with externalizing mental health problems was less prominent.
ERIC Educational Resources Information Center
Smith, Pheny Zhou
The growing number of international students and exchange scholars enrolled in American colleges and universities each year has called attention to the need to provide special mental health services to help international students adjust to the host culture and solve various mental health problems. According to Alderian therapy, people are…
Rehabilitation of the Mentally Ill: An International Perspective.
ERIC Educational Resources Information Center
Schulman, Eveline D.
This monograph is an international overview of available information about the current status of rehabilitation efforts for the mentally ill. It served as a springboard for discussion at the Special Interest Group session at the Fourteenth World Congress of Rehabilitation International in Winnipeg, Canada, on June, 1980. The first part of the…
International Terrorism and Mental Health: Recent Research and Future Directions
ERIC Educational Resources Information Center
Fischer, Peter; Ai, Amy L.
2008-01-01
International terrorism has become a major global concern. Several studies conducted in North America and Europe in the aftermath of terrorist attacks reveal that international terrorism represents a significant short-term and long-term threat to mental health. In the present article, the authors clarify the concept and categories of terrorism and…
Makanjuola, Victor; Esan, Yomi; Oladeji, Bibilola; Kola, Lola; Appiah-Poku, John; Harris, Benjamin; Othieno, Caleb; Price, Leshawndra; Seedat, Soraya; Gureje, Oye
2016-12-01
Most cultures in sub-Saharan Africa subscribe to the belief that the root cause of psychosis is supernatural. Individuals in the community who hold a religiomagical explanatory model of causation have been shown to exhibit more stigmatizing attitudes towards people with psychosis. Self-stigma among individuals with psychosis is less frequently studied. We used a mixed-method approach, consisting of key informant's interviews to elicit information on explanatory models of causation of psychosis and questionnaire assessment of internalized stigma with an adapted version of the Scale for Internalized Stigma of Mental Illness. Twenty-four, 31, and 30 subjects with recent experience of utilizing the service of traditional or faith healers for severe mental disorders in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya), respectively, were interviewed. About 44 % (42.1 %) of the Nigerian respondents had a high (severe) level of self-stigma with the respective proportions among Ghanaian and Kenyan respondents being 20.7 and 37.5 %. Compared with 4 out of a total of 12 respondents (33.3 %) who reported low self-stigma reported supernatural attribution, 14 out of 20 respondents (70 %) with the highest level of self-stigma reported supernatural attribution across the three sites. When low scorers ascribed supernatural causation, it was often with a religious focus. There is a greater tendency for persons with high levels of self-stigma than those with low levels to ascribe supernatural attribution to their experience of a severe mental health condition.
Identifying Priorities for Mental Health Interventions in War-Affected Youth: A Longitudinal Study.
Betancourt, Theresa S; Gilman, Stephen E; Brennan, Robert T; Zahn, Ista; VanderWeele, Tyler J
2015-08-01
War-affected youth often suffer from multiple co-occurring mental health problems. These youth often live in low-resource settings where it may be infeasible to provide mental health services that simultaneously address all of these co-occurring mental health issues. It is therefore important to identify the areas where targeted interventions would do the most good. This analysis uses observational data from 3 waves of a longitudinal study on mental health in a sample of 529 war-affected youth (24.2% female; ages 10-17 at T1, 2002) in Sierra Leone. We regressed 4 mental health outcomes at T3 (2008) on internalizing (depression/anxiety) and externalizing (hostility/aggression) problems and prosocial attitudes/behaviors and community variables at T2 (2004) controlling for demographics, war exposures, and previous mental health scores at T1, allowing us to assess the relative impact of potential mental health intervention targets in shaping mental health outcomes over time. Controlling for baseline covariates at T1 and all other exposures/potential intervention targets at T2, we observed a significant association between internalizing problems at T2 and 3 of the 4 outcomes at T3: internalizing (β = 0.27, 95% confidence interval [CI]: 0.11-0.42), prosocial attitudes (β = -0.20, 95% CI: -0.33 to -0.07) and posttraumatic stress symptoms (β = 0.22, 95% CI: 0.02-0.43). No other potential intervention target had similar substantial effects. Reductions in internalizing may have multiple benefits for other mental health outcomes at a later point in time, even after controlling for confounding variables. Copyright © 2015 by the American Academy of Pediatrics.
Mental incapacity defenses at the War Crimes Tribunal: questions and controversy.
Sparr, Landy F
2005-01-01
Following a report from the Secretary General in May 1993, the United Nations Security Council adopted Resolution 827 and its Statute establishing an International War Crimes Tribunal for the Former Yugoslavia (ICTY) located in The Hague, The Netherlands. Although such action has been discussed in the past, this is the first time the international community has established a tribunal to indict and try individuals for war crimes. The crimes had been previously "created" by multilateral international treaties. The ICTY Rules of Procedure and Evidence allowed for "any special defense, including that of diminished or lack of mental responsibility." Precise legal parameters of the defense were not specified. In 1998, a defendant at the ICTY "Celebici" Trial named Esad Landzo raised the defense of diminished mental responsibility. The Celebici Trial Chamber thus became the first legal body to consider reduced mental capacity as it applies to international criminal law. This article is an examination of the application of the affirmative defense of diminished responsibility at the ICTY and relates the process to the need for further definition of mental incapacity defenses at the newly established International Criminal Court (ICC). At the ICC preparatory commission, drafting material elements of crimes was emphasized, with less consideration given to mental elements. That diminished capacity and diminished-responsibility defenses have often confused scholars and practitioners alike is explored in this article with suggestions for further directions.
2014-11-04
learning by robots as well as video image understanding by accumulated learning of the exemplars are discussed. 15. SUBJECT TERMS Cognitive ...learning to predict perceptual streams or encountering events by acquiring internal models is indispensable for intelligent or cognitive systems because...various cognitive functions are based on this compentency including goal-directed planning, mental simulation and recognition of the current situation
Utility of the Montreal Assessment of Need Questionnaire for Community Mental Health Planning
Tremblay, Jacques; Bamvita, Jean-Marie; Grenier, Guy; Fleury, Marie-Josée
2014-01-01
Abstract Needs assessment facilitates mental health services planning, provision, and evaluation. This study aimed to a) validate a new instrument, the Montreal Assessment of Needs Questionnaire (MANQ), and b) use this to assess variations and predictors of need (number and seriousness) in 297 individuals with severe mental disorders for 18 months, during implementation of the Quebec Mental Health Action Plan. MANQ internal and external validations were adequate. Variables significantly associated with need number and seriousness variations were used to build multiple linear regression models. Autonomous housing, not receiving welfare, not having consulted a health educator, higher level of help from services, Alcohol Use Disorders Identification Test total score, and social support were associated with decreasing need number and seriousness over time. Having a higher education was also associated with decreasing need number. In a reform context, the MANQ’s unique ability to detect rapid improvement in patient needs has usefulness for Quebec mental health planning. PMID:25099300
Webb-Murphy, Jennifer A; De La Rosa, Gabriel M; Schmitz, Kimberly J; Vishnyak, Elizabeth J; Raducha, Stephanie C; Roesch, Scott C; Johnston, Scott L
2015-12-01
Military personnel deployed to Joint Task Force Guantanamo Bay (JTF-GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF-GTMO completed several validated self-report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF-GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF-GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R2 values ranging from .02 to .11. Occupation at JTF-GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF-GTMO deployment was associated with significant psychological stress, and that both job-related and attitude-related variables were important to understanding mental health symptoms in this sample. Copyright © 2015 International Society for Traumatic Stress Studies.
Collective Efficacy and the Contingent Consequences of Exposure to Life-Threatening Violence1
Browning, Christopher R.; Gardner, Margo; Maimon, David; Brooks-Gunn, Jeanne
2014-01-01
Neighborhood research has increasingly emphasized the potential for contextual characteristics to moderate the effects of youths’ experiences on their outcomes. Drawing on collective efficacy theory, we examine the variable consequences of youths’ exposures to life threatening violence across neighborhoods. We argue that strong community normative orientations supporting the control of violence diminish the negative effect of exposure to severe violence on subsequent mental health among urban youth. We also consider the extent to which the consequences of exposure to violence vary by gender. Employing data from the Project on Human Development in Chicago Neighborhoods, we estimate a series of multivariate, multilevel linear models of internalizing and externalizing symptoms. Results indicate that, for girls, exposure to life threatening violence (witnessing someone being attacked with a weapon or shot) increases both internalizing and externalizing symptoms. However, this effect achieves statistical significance only for girls who reside in lower collective efficacy neighborhoods. For boys, our analyses offered weaker evidence of violence exposure effects on mental health. Implications for research on the social context of mental health are discussed. PMID:24842460
Fan, Zhiwei; He, Shuchang
2013-11-01
To investigate Beijing college students' self-consciousness and its relationship with mental health. Convenient samples of 928 college students from five universities in Beijing were inquired and assessed with the self-consciousness scale and the Kessler 10 psychological distress scale. Confirmatory factor analysis and structural equation modeling were used to analyze the data. College students' scores of self-consciousness did not differ in sex, age, grade and major type. 83.5% of the participants had relatively low scores (10-24) of psychological distress, but those of the students of liberal arts were higher (P < 0.05). The measurement data of self-consciousness supported Mittal and Balasubramanian' s five-factor structure. Self-reflectiveness was positively correlated with depression (P < 0.05). Internal state awareness was negatively associated with both anxiety and depression (P < 0.05). Style consciousness was positively correlated with both of them (P < 0.001). Beijing college students' self-consciousness is relatively high and has a relatively complex structure. While self-reflectiveness and style consciousness have negative effects, internal state awareness is good for mental health.
Chemical Dependency Regional Needs Assessment: Northeastern Minnesota.
ERIC Educational Resources Information Center
Stone, Marylee
The Minnesota Model of Chemical Dependency Treatment, which evolved from a combination of the grassroots Alcoholics Anonymous movement and the State Mental Health Services in the 1960s has made Minnesota an international leader in chemical dependency treatment efforts. Northeastern Minnesota has shared this reputation with the state. In spite of…
Mental health from the perspective of primary care residents: a pilot survey.
Iskandar, Joseph W; Sharma, Taral; Alishayev, Ilya; Mingoia, Joseph; Vance, John Eric; Ali, Rizwan
2014-01-01
Primary care physicians are increasingly providing psychiatric care in the United States. Unfortunately, there is limited learning opportunity or exposure to psychiatry during their residency training. This survey was conducted to assess primary care resident interaction with mental health professionals and their satisfaction, knowledge, preference, and comfort with the delivery of mental health care in primary health care settings. On the basis of available published literature, a 20-question survey was formulated. Following receipt of the institutional review board's approval, these questions were sent via e-mail in February 2012 to internal and family medicine residents (N = 108) at 2 teaching hospitals in southwest Virginia. Analysis of the electronically captured data resulted in a response rate of 32%. Descriptive analysis was used to examine the results. The responses were equally divided among male and female residents and family medicine and internal medicine residents. There were several interesting findings from the survey. No correlations were noted between the gender of residents, type or location of the medical school, or having had a psychiatric rotation during residency and the reported comfort level treating patients with psychiatric illness or the desire to see psychiatric patients in the future. A positive correlation was found between the residents' training level and their belief about the percentage of mental health providers who have mental health problems. The current training model to acclimate primary care residents to the field of mental health appears to have major limitations. RESULTS of this pilot survey can serve as a guide to conduct prospective, multicenter studies to identify and improve psychiatric training for primary care residency programs.
Kira, Ibrahim A; Lewandowski, Linda; Ashby, Jeffrey S; Templin, Thomas; Ramaswamy, Vidya; Mohanesh, Jamal
2014-07-01
Understanding the dynamics of mental health stigma through existing frameworks, especially in minorities with higher stigma, is problematic. There is a need to reconceptualize stigma, particularly in highly traumatized groups. The current study examines the validity of a new development-based trauma framework that conceptualizes stigma as a type III chronic trauma that contributes to negative mental health effects. This framework proposes that public stigma is a unique chronic traumatic stress that mediates the effects of similar trauma types in mental health patients. To test this proposition, this study explores the relationships between internalized stigma of mental illness (ISMI), different trauma types, and posttrauma spectrum disorders. ISMI, posttraumatic stress disorder, other posttrauma spectrum disorders, and cumulative trauma measures were administered to a sample of 399 mental health patients that included Arab (82%), Muslim (84%), and refugee (31%), as well as American patients (18%). Age in the sample ranged from 18 to 76 years (M = 39.66, SD = 11.45), with 53.5% males. Hierarchical multiple regression, t tests, and path analyses were conducted. Results indicated that ISMI predicted posttraumatic stress disorder and other posttrauma spectrum disorders after controlling for cumulative trauma. ISMI was associated with other chronic collective identity traumas. While Arab Americans, Muslims, and refugees had higher ISMI scores than other Americans, the elevated chronic trauma levels of these groups were significant predictors of these differences. The results provide evidence to support ISMI traumatology model. Implications of the results for treating victims of ISMI, especially Arab Americans, Muslims and refugees are discussed. © The Author(s) 2014.
Impact of psychiatry training on attitude of medical students toward mental illness and psychiatry
Gulati, Prannay; Das, Subhash; Chavan, B. S.
2014-01-01
Context: Attitude of fresh graduates toward psychiatric patients is important to bridge the treatment gap due to mental illness. Psychiatry as a subject has been neglected in the undergraduates of MBBS. Aims: (1) To compare the attitude of medical students and interns in a medical college toward mental illness and psychiatry. (2) To assess the impact of psychiatric training on attitude toward the mentally ill person and mental illness. Settings and Design: Cross-sectional, single assessment study conducted at a tertiary hospital. Subjects and Methods: Participants consisted of medical students of 1st and 2nd year who didn’t have any exposure to psychiatry and interns, who had completed their compulsory 2 week clinical posting in psychiatry. Participants were individually administered sociodemographic proforma, General Health Questionnaire-12 (GHQ-12), opinion about mental illness (OMI) scale, and attitude to psychiatry-29 (ATP-29) scale. Statistical Analysis: Standard descriptive statistics (mean, percentage), Chi-square test. Results: A total of 135 participants formed the study sample, with 48, 47, and 40 participants from 1st year, 2nd year and interns, respectively. Mean GHQ score was 14.03 for the entire sample. There was better outlook of interns toward psychiatry and patients with mental disorders in comparison to fresh graduate students in some areas. Overall, negative attitude toward mental illness and psychiatry was reflected. Conclusions: Exposure to psychiatry as per the current curriculum seems to have a limited influence in bringing a positive change in OMI and psychiatry. PMID:25316938
Lee, S.; Tsang, A.; Breslau, J.; Aguilar-Gaxiola, S.; Angermeyer, M.; Borges, G.; Bromet, E.; Bruffaerts, R.; de Girolamo, G.; Fayyad, J.; Gureje, O.; Haro, J. M.; Kawakami, N.; Levinson, D.; Browne, M. A. Oakley; Ormel, J.; Posada-Villa, J.; Williams, D. R.; Kessler, R. C.
2009-01-01
Background Studies of the impact of mental disorders on educational attainment are rare in both high-income and low- and middle-income (LAMI) countries. Aims To examine the association between early-onset mental disorder and subsequent termination of education. Method Sixteen countries taking part in the World Health Organization World Mental Health Survey Initiative were surveyed with the Composite International Diagnostic Interview (n=41 688). Survival models were used to estimate associations between DSM–IV mental disorders and subsequent non-attainment of educational milestones. Results In high-income countries, prior substance use disorders were associated with non-completion at all stages of education (OR 1.4–15.2). Anxiety disorders (OR=1.3), mood disorders (OR=1.4) and impulse control disorders (OR=2.2) were associated with early termination of secondary education. In LAMI countries, impulse control disorders (OR=1.3) and substance use disorders (OR=1.5) were associated with early termination of secondary education. Conclusions Onset of mental disorder and subsequent non-completion of education are consistently associated in both high-income and LAMI countries. PMID:19407270
Physical and mental health disparities among young children of Asian immigrants.
Huang, Keng-Yen; Calzada, Esther; Cheng, Sabrina; Brotman, Laurie Miller
2012-02-01
To examine physical and mental health functioning among Asian-American children of US-born and immigrant parents. We used data from the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999 base-year public data file. The sample was restricted to 7726 Asian and US-born white children. Asian subgroups were created based on parents' country of birth. Child physical and mental health was assessed based on multiple sources of data and measures. Analyses included multivariate linear and logistic regression. After adjusting for demographic and contextual differences, disparities were found for physical and mental health indicators. Children of foreign-born Asian families (from east, southeast, and south Asia) were at greater risk for poor physical health, internalizing problems, and inadequate interpersonal relationships compared with children of US-born white families. There is little support for the "model minority" myth with regard to physical and mental health. Evidence of physical and mental health disparities among young Asian-American children and differing risk based on region of origin of immigrant parents suggests the need for culturally informed prevention efforts during early childhood. Copyright © 2012 Mosby, Inc. All rights reserved.
The Impact of Minority Stress on Mental Health and Substance Use Among Sexual Minority Women
Lehavot, Keren; Simoni, Jane M.
2014-01-01
Objective We examined the direct and indirect impact of minority stress on mental health and substance use among sexual minority women. Method A combination of snowball and targeted sampling strategies was used to recruit lesbian and bisexual women (N = 1,381) for a cross-sectional, online survey. Participants (M age = 33.54 years; 74% White) completed a questionnaire assessing gender expression, minority stressors (i.e., victimization, internalized homophobia, and concealment), social–psychological resources (i.e., social support, spirituality), and health-related outcomes. We used structural equation modeling to test associations among these factors, with gender expression as an antecedent and social–psychological resources as a mediator between minority stress and health. Results The final model demonstrated acceptable fit, χ2(79) = 414.00, p < .05, confirmatory fit index = .93, Tucker–Lewis index = .91, standardized root-mean-square residual = .05, root-mean-square error of approximation = .06, accounting for significant portions of the variance in mental health problems (56%) and substance use (14%), as well as the mediator social–psychological resources (24%). Beyond indirect effects of minority stress on health outcomes, direct links emerged between victimization and substance use and between internalized homophobia and substance use. Conclusions Findings indicate a significant impact of minority stressors and social–psychological resources on mental health and substance use among sexual minority women. The results improve understanding of the distinct role of various minority stressors and their mechanisms on health outcomes. Health care professionals should assess for minority stress and coping resources and refer for evidence-based psychosocial treatments. PMID:21341888
The impact of minority stress on mental health and substance use among sexual minority women.
Lehavot, Keren; Simoni, Jane M
2011-04-01
We examined the direct and indirect impact of minority stress on mental health and substance use among sexual minority women. A combination of snowball and targeted sampling strategies was used to recruit lesbian and bisexual women (N = 1,381) for a cross-sectional, online survey. Participants (M age = 33.54 years; 74% White) completed a questionnaire assessing gender expression, minority stressors (i.e., victimization, internalized homophobia, and concealment), social-psychological resources (i.e., social support, spirituality), and health-related outcomes. We used structural equation modeling to test associations among these factors, with gender expression as an antecedent and social-psychological resources as a mediator between minority stress and health. The final model demonstrated acceptable fit, χ²(79) = 414.00, p < .05, confirmatory fit index = .93, Tucker-Lewis index = .91, standardized root-mean-square residual = .05, root-mean-square error of approximation = .06, accounting for significant portions of the variance in mental health problems (56%) and substance use (14%), as well as the mediator social-psychological resources (24%). Beyond indirect effects of minority stress on health outcomes, direct links emerged between victimization and substance use and between internalized homophobia and substance use. Findings indicate a significant impact of minority stressors and social-psychological resources on mental health and substance use among sexual minority women. The results improve understanding of the distinct role of various minority stressors and their mechanisms on health outcomes. Health care professionals should assess for minority stress and coping resources and refer for evidence-based psychosocial treatments. (c) 2011 APA, all rights reserved.
International terrorism and mental health: recent research and future directions.
Fischer, Peter; Ai, Amy L
2008-03-01
International terrorism has become a major global concern. Several studies conducted in North America and Europe in the aftermath of terrorist attacks reveal that international terrorism represents a significant short-term and long-term threat to mental health. In the present article, the authors clarify the concept and categories of terrorism and then present central findings from studies conducted in the United States and Europe, which mainly focus on negative impacts on mental health, such as emotional stress and PTSD. Furthermore, the authors outline experiments that focus on social interaction processes thought to be triggered by international terrorism and which are assumed to be related indirectly to mental health processes. Next, they highlight the potential positive outcomes on the resilience side, in line with the current theory on posttraumatic growth in adversity. Finally, theoretical and practical implications as well as limitations and future directions are discussed.
Understanding pain and coping in women with interstitial cystitis/bladder pain syndrome.
Katz, Laura; Tripp, Dean A; Carr, Lesley K; Mayer, Robert; Moldwin, Robert M; Nickel, J Curtis
2017-08-01
To examine a self-regulation and coping model for interstitial cystitis/bladder pain syndrome (IC/BPS) that may help us understand the pain experience of patients with chronic IC/BPS. The model tested illness perceptions, illness-focused coping, emotional regulation, mental health and disability in a stepwise method using factor analysis and structural equation modelling. Step 1, explored the underlying constructs. Step 2, confirmed the measurement models to determine the structure/composition of the main constructs. Step 3, evaluated the model fit and specified pathways in the proposed IC/BPS self-regulation model. In all, 217 female patients with urologist diagnosed IC/BPS were recruited and diagnosed across tertiary care centres in North America. The data were collected through self-report questionnaires. An IC/BPS self-regulation model was supported. Physical disability was worsened by patient's negative perception of their illness, attempts to cope using illness-focused coping and poorer emotional regulation. Mental health was supported by perceptions that individuals could do something about their illness, using wellness-focused behavioural strategies and adaptive emotion regulation. The results clarify the complex and unique process of self-regulation in women with IC/BPS, implicating cognitive and coping targets, and highlighting emotional regulation. This knowledge should help clinicians understand and manage these patients' distress and disability. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.
Quantum decision-maker theory and simulation
NASA Astrophysics Data System (ADS)
Zak, Michail; Meyers, Ronald E.; Deacon, Keith S.
2000-07-01
A quantum device simulating the human decision making process is introduced. It consists of quantum recurrent nets generating stochastic processes which represent the motor dynamics, and of classical neural nets describing the evolution of probabilities of these processes which represent the mental dynamics. The autonomy of the decision making process is achieved by a feedback from the mental to motor dynamics which changes the stochastic matrix based upon the probability distribution. This feedback replaces unavailable external information by an internal knowledge- base stored in the mental model in the form of probability distributions. As a result, the coupled motor-mental dynamics is described by a nonlinear version of Markov chains which can decrease entropy without an external source of information. Applications to common sense based decisions as well as to evolutionary games are discussed. An example exhibiting self-organization is computed using quantum computer simulation. Force on force and mutual aircraft engagements using the quantum decision maker dynamics are considered.
Ellis, Horace; Alexander, Vinette
2016-06-01
There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in the development of innovative, revolutionary, and transformative paradigmatic models aimed at eradicating treatment barriers, promoting well-being, and reducing preventable mortalities and morbidities among SMI persons. Copyright © 2016 Elsevier Inc. All rights reserved.
Callwood, Alison; Cooke, Debbie; Bolger, Sarah; Lemanska, Agnieszka; Allan, Helen
2018-01-01
Universities in the United Kingdom (UK) are required to incorporate values based recruitment (VBR) into their healthcare student selection processes. This reflects an international drive to strengthen the quality of healthcare service provision. This paper presents novel findings in relation to the reliability and predictive validity of multiple mini interviews (MMIs); one approach to VBR widely being employed by universities. To examine the reliability (internal consistency) and predictive validity of MMIs using end of Year One practice outcomes of under-graduate pre-registration adult, child, mental health nursing, midwifery and paramedic practice students. Cross-discipline evaluation study. One university in the United Kingdom. Data were collected in two streams: applicants to A) The September 2014 and 2015 Midwifery Studies programmes; B) September 2015 adult; Child and Mental Health Nursing and Paramedic Practice programmes. Fifty-seven midwifery students commenced their programme in 2014 and 69 in 2015; 47 and 54 agreed to participate and completed Year One respectively. 333 healthcare students commenced their programmes in September 2015. Of these, 281 agreed to participate and completed their first year (180 adult, 33 child and 34 mental health nursing and 34 paramedic practice students). Stream A featured a seven station four-minute model with one interviewer at each station and in Stream B a six station model was employed. Cronbach's alpha was used to assess MMI station internal consistency and Pearson's moment correlation co-efficient to explore associations between participants' admission MMI score and end of Year one clinical practice outcomes (OSCE and mentor grading). Stream A: Significant correlations are reported between midwifery applicant's MMI scores and end of Year One practice outcomes. A multivariate linear regression model demonstrated that MMI score significantly predicted end of Year One practice outcomes controlling for age and academic entry level: coefficients 0.195 (p=0.002) and 0.116 (p=0.002) for OSCE and mentor grading respectively. In Stream B no significant correlations were found between MMI score and practice outcomes measured by mentor grading. Internal consistency for each MMI station was 'excellent' with values ranging from 0.966-0.974 across Streams A and B. This novel, cross-discipline study shows that MMIs are reliable VBR tools which have predictive validity when a seven station model is used. These data are important given the current international use of different MMI models in healthcare student selection processes. Copyright © 2017. Published by Elsevier Ltd.
The Effects of Religion and Locus of Control on Perception of Mental Illness.
Amedome, Sedem Nunyuia; Bedi, Innocent Kwame
2018-06-23
The study investigated the influence of religion and locus of control on perception of mental illness. Specifically, the study explored the relationship between religiosity and perception of mental illness, differences in perception by internals and externals, the effect of knowledge on perception of mental illness and the interactive effect of religiosity and locus of control on perception of mental illness. Data were collected from 200 participants in the Volta Region of Ghana. Three hypotheses were tested in the study using a battery of tests. It was observed that people with internal locus of control perceive mental patients positively than those with external locus of control. A significant interactive effect between religiosity and locus of control on perception of mental illness was observed. Religiosity significantly relates to perception of mental illness. The results and implications are discussed for further studies.
ERIC Educational Resources Information Center
Yang, Ningxi; Xu, Yayun; Chen, Xinguang; Yu, Bin; Yan, Hong; Li, Shiyue
2018-01-01
Objectives: Engaging in sexual risk behaviour can be a maladaptive strategy for international students to deal with stress. This study examined the role of poor mental health in mediating the relationship between acculturative stress and condom-use intention among international students in Beijing, China. Methods: The study used a cross-sectional…
Adult mental health needs and expenditure in Australia.
Burgess, Philip; Pirkis, Jane; Buckingham, Bill; Burns, Jane; Eagar, Kathy; Eckstein, Gary
2004-06-01
Relatively little international work has examined whether mental health resource allocation matches need. This study aimed to determine whether adult mental health resources in Australia are being distributed equitably. Individual measures of need were extrapolated to Australian Areas, and Area-based proxies of need were considered. Particular attention was paid to the prevalence of mental health problems, since this is arguably the most objective measure of need. The extent to which these measures predicted public sector, private sector and total adult mental health expenditure at an Area level was examined. In the public sector, 41.6% of expenditure variation was explained by the prevalence of affective disorders, personality disorders, cognitive impairment and psychosis, as well as the Area's level of economic resources and State/Territory effects. In the private sector, 72.4% of expenditure variation was explained by service use and State/Territory effects (with an alternative model incorporating service use and State/Territory supply of private psychiatrists explaining 69.4% of expenditure variation). A relatively high proportion (58.7%) of total expenditure variation could be explained by service utilisation and State/Territory effects. For services to be delivered equitably, the majority of variation in expenditure would have to be accounted for by appropriate measures of need. The best model for public sector expenditure included an appropriate measure of need but had relatively poor explanatory power. The models for private sector and total expenditure had greater explanatory power, but relied on less appropriate measures of need. It is concluded that mental health services in Australia are not yet being delivered equitably.
Yanos, Philip T.; Roe, David; Lysaker, Paul H.
2011-01-01
Internalized stigma has been suggested to play a major role in negative changes in identity in severe mental illness. Evidence suggests that roughly one-third of people with severe mental illness show elevated internalized stigma and that it is linked to compromised outcomes in both subjective and objective aspects of recovery. Despite substantial evidence for the impact of internalized stigma, few efforts have been made to develop professionally-led treatment to address this issue. In this article, we discuss our development of a new, group-based approach to the treatment of internalized stigma which we have termed “narrative enhancement and cognitive therapy” (NECT). We describe the treatment approach and offer an illustration of it by way of a case vignette. PMID:21985260
An analysis of the functioning of mental healthcare in northwestern Poland.
Bażydło, Marta; Karakiewicz, Beata
Modern psychiatry faces numerous challenges related with the change of the epidemiology of mental disorders and the development of knowledge in this area of science. An answer to this situation is to be the introduction of community psychiatry. The implementation of this model in Poland was the aim of the National Mental Health Protection Programme. The aim of the study was to analyse the functioning of mental healthcare using the example of the West Pomeranian Province in Poland. The analysis relied on a qualitative method. Three group interviews in an interdisciplinary advisory panel were conducted. People representing various areas acting for people with mental disorders participated in each meeting. Based on the conclusions that were drawn, PEST and SWOT analyses of functioning of mental healthcare were performed. Within the analysis of the macro-environment of mental healthcare, the influence of the following factors was evaluated through PEST analysis: political and legal, economic, socio-cultural, and technological. All of these factors were assessed as negative for the functioning of mental healthcare. Then, a SWOT analysis was performed to indicate the strengths, weaknesses, opportunities, and threats in the functioning of mental healthcare. 1. Mental healthcare is more influenced by external factors than by internal factors. 2. Macro-environmental factors influence the functioning of mental healthcare in a significantly negative manner. 3. The basic problem in the functioning of mental healthcare is insufficient funding. 4. In order to improve the functioning of mental healthcare, it is necessary to change the funding methods, regulations, the way society perceives mental disorders, and the system of monitoring mental healthcare services.
ERIC Educational Resources Information Center
Academy of Pedagogical Sciences of the USSR, Moscow. Inst. of Defectology.
Presented are 14 reports given by members of the Institute of Defectology in Moscow to the First Congress of the International Association for the Scientific Study of Mental Deficiency held in Montpellier, France, in 1967. The papers have the following titles: "The Soviet Education Scheme for Mentally Retarded Children", "Main…
Instruments for measuring mental health recovery: a systematic review.
Sklar, Marisa; Groessl, Erik J; O'Connell, Maria; Davidson, Larry; Aarons, Gregory A
2013-12-01
Persons in recovery, providers, and policymakers alike are advocating for recovery-oriented mental health care, with the promotion of recovery becoming a prominent feature of mental health policy in the United States and internationally. One step toward creating a recovery-oriented system of care is to use recovery-oriented outcome measures. Numerous instruments have been developed to assess progress towards mental health recovery. This review identifies instruments of mental health recovery and evaluates the appropriateness of their use including their psychometric properties, ease of administration, and service-user involvement in their development. A literature search using the Medline and Psych-INFO databases was conducted, identifying 21 instruments for potential inclusion in this review, of which thirteen met inclusion criteria. Results suggest only three instruments (25%) have had their psychometric properties assessed in three or more unique samples of participants. Ease of administration varied between instruments, and for the majority of instruments, development included service user involvement. This review updates and expands previous reviews of instruments to assess mental health recovery. As mental health care continues to transform to a recovery-oriented model of service delivery, this review may facilitate selection of appropriate assessments of mental health recovery for systems to use in evaluating and improving the care they provide. © 2013.
Mental Health Treatment Seeking Among Older Adults with Depression: The Impact of Stigma and Race
Conner, Kyaien O.; Copeland, Valire Carr; Grote, Nancy K.; Koeske, Gary; Rosen, Daniel; Reynolds, Charles F.; Brown, Charlotte
2010-01-01
Objective Stigma associated with mental illness continues to be a significant barrier to help seeking, leading to negative attitudes about mental health treatment and deterring individuals who need services from seeking care. This study examined the impact of public stigma (negative attitudes held by the public) and internalized stigma (negative attitudes held by stigmatized individuals about themselves) on racial differences in treatment seeking attitudes and behaviors among older adults with depression. Method Random digit dialing was utilized to identify a representative sample of 248 African American and White adults older adults (over the age of 60) with depression (symptoms assessed via the Patient Health Questionnaire-9). Telephone based surveys were conducted to assess their treatment seeking attitudes and behaviors, and the factors that impacted these behaviors. Results Depressed older adult participants endorsed a high level of public stigma and were not likely to be currently engaged in, nor did they intend to seek mental health treatment. Results also suggested that African American older adults were more likely to internalize stigma and endorsed less positive attitudes toward seeking mental health treatment than their White counterparts. Multiple regression analysis indicated that internalized stigma partially mediated the relationship between race and attitudes toward treatment. Conclusion Stigma associated with having a mental illness has a negative influence on attitudes and intentions toward seeking mental health services among older adults with depression, particularly African American elders. Interventions to target internalized stigma are needed to help engage this population in psychosocial mental health treatments. PMID:20220602
Commentary: civil commitment and its reform.
Simpson, Alexander I F
2015-03-01
Internationally, civil commitment laws have gone through substantial reforms in the past 50 years. Discernible shifts from the medically paternalistic to the excessively legalistic may be giving way to a blending of legislative intent under the rubric of therapeutic jurisprudence. In the light of those international movements, Shao and Xie describe how China's new mental health law shows the impact of these international and local influences on the development and practice of mental health law in China. The new Law was passed in 2012. It sets a broad vision for mental health services and mental health promotion in Chinese society as well as providing the legal framework for civil commitment. Practicalities of implementation may be highly significant in the success of the legislation. © 2015 American Academy of Psychiatry and the Law.
Van Loon, Linda M A; Van de Ven, Monique O M; Van Doesum, Karin T M; Hosman, Clemens M H; Witteman, Cilia L M
2017-03-01
When adolescents live with a parent with mental illness, they often partly take over the parental role. Little is known about the consequences of this so-called parentification on the adolescents' internalizing and externalizing problems. This survey study examined this effect cross-sectionally and longitudinally in a sample of 118 adolescents living with a parent suffering from mental health problems. In addition, the study examined a possible indirect effect via perceived stress. Path analyses were used to examine the direct associations between parentification and problem behavior as well as the indirect relations via perceived stress. The results showed that parentification was associated with both internalizing and externalizing problems cross-sectionally, but it predicted only internalizing problems 1 year later. An indirect effect of parentification on adolescent internalizing and externalizing problems via perceived stress was found, albeit only cross-sectionally. These findings imply that parentification can be stressful for adolescents who live with a parent with mental health problems, and that a greater awareness of parentification is needed to prevent adolescents from developing internalizing problems. © 2015 Family Process Institute.
Bergeron, Félix-Antoine; Blais, Martin; Hébert, Martine
Introduction Sexual-minority youths (SMY) report high rates of psychological distress such as depression, anxiety and suicidal ideation (Burton, Marshal, Chisolm, Sucato et Friedman, 2013; Williams & Chapman, 2011). Several studies confirm that the poor mental health outcomes are partly related to their high likelihood of experiencing homophobic victimization (Blais, Gervais, Boucher, Hébert & Lavoie, 2013; Taylor & Peter, 2011; Hughes, McCabe, Wilsnack, West & Boyd, 2010; Chamberland, Richard & Bernier, 2013). Whereas the development of a positive sexual minority identity is crucial for the mental health of SMY (Chamberland, Richard & Chevrier, 2011; Rosario, Schrimshaw & Hunter, 2011; Luhtanen, 2002), the victimization they experience put them at risk of internalizing societal homophobia and heterosexism (Meyer, 2003; Hatzenbuehler, 2009). It is important to identify variables that may influence the impact of distal and proximal factors that impact SMY's mental health.Objectives The objectives of this paper are 1) to document different forms of homophobic victimization experienced by SMY, according to gender and age, and 2) to test the potential moderating effect of parental support in the relationship between homophobic victimization, internalized homophobia and psychological distress.Method Data come from 228 SMY aged 14 to 22 years old recruited through online means as part of the Quebec Youth's Romantic Relationships Survey. The impact of homophobic victimization, parental support, and internalized homophobia on psychological distress is explored by a linear regression model including moderated mediation effects.Results Results show the relationship between homophobic victimization and psychological distress as well as indirect significant relationship through internalized homophobia. The moderated mediation analysis also confirms the moderating role of parental support in the relationship between homophobic victimization and psychological distress. Thus, at equal level of victimization, participants with low parental support experienced more psychological distress. However, parental support did not lessen the impact of victimization on internalized homophobia. The linear regression model explains 22.5% of the variance in psychological distress and 6.6% of the variance of internalized homophobia.Conclusion The results emphasize the importance of continuing efforts to prevent homophobic behaviors and attitudes among school staff, parents as well as employers and colleagues in the workplace. Given their key role, parents must also be educated and trained to support their gay, lesbian, bisexual or questioning children.
Mental health of adolescents before and after the death of a parent or sibling.
Stikkelbroek, Yvonne; Bodden, Denise H M; Reitz, Ellen; Vollebergh, Wilma A M; van Baar, Anneloes L
2016-01-01
The death of a parent or sibling (family bereavement) is associated with mental health problems in approximately, 25 % of the affected children. However, it is still unknown whether mental health problems of family-bereaved adolescents are predicted by pre-existing mental health problems, pre-loss family functioning, or multiple bereavements. In this study, a prospective longitudinal assessment of change in mental health following bereavement was done in a large representative sample from the 'Tracking Adolescents Individual Lives Survey' (TRAILS). This is a four-wave prospective cohort study of Dutch adolescents (n = 2230) of whom 131 (5.9 %) had experienced family bereavement at the last wave (T4). Family-bereaved adolescents reported more internalizing problems, within 2 years after family bereavement, compared to the non-bereaved peers, while taking into account the level of internalizing problems before the bereavement. A clinically relevant finding was that 22 % new cases were found in family-bereaved, in comparison to 5.5 % new cases in non-bereaved. Low SES predicted more internalizing problems in family-bereaved but not in non-bereaved adolescents. Family functioning, reported by the adolescent, did not predict mental health problems within 2 years. Multiple family bereavements predicted fewer externalizing problems. In conclusion, internalizing problems increase in adolescents after family bereavement in comparison to non-bereaved and these can be predicted by pre-loss factors. Awareness among professionals regarding the risks for aggravation of mental health problems after family loss is needed.
Blasco, Maria Jesús; Castellví, Pere; Almenara, José; Lagares, Carolina; Roca, Miquel; Sesé, Albert; Piqueras, José Antonio; Soto-Sanz, Victoria; Rodríguez-Marín, Jesús; Echeburúa, Enrique; Gabilondo, Andrea; Cebrià, Ana Isabel; Miranda-Mendizábal, Andrea; Vilagut, Gemma; Bruffaerts, Ronny; Auerbach, Randy P; Kessler, Ronald C; Alonso, Jordi
2016-05-04
Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain. An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models. The study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.
Monfort, Samuel S; Howe, George W; Nettles, Christopher D; Weihs, Karen L
2015-01-01
Underemployed workers-those receiving less pay, working fewer hours, or using fewer skills than they would prefer-appear to experience negative mental health outcomes similar to the unemployed. Prior cross-sectional research provides mixed empirical evidence for this conclusion, however. The current study sought to clarify the impact of underemployment longitudinally, assessing mental health 5 times over 8 months after job loss. In addition to the commonly used indicators of underemployment, we designed a measure of cognitive complexity using the Occupational Information Network (O*NET), an extensive government database used to organize and categorize occupational information. Replicating past research, we found concurrent associations between all indexes of reemployment job quality and internalizing symptoms in the period immediately after reemployment. However, when controlling for quality of prior employment, all indicators except our measure for cognitive complexity became nonsignificant. As participants transitioned from unemployment to reemployment, only reductions in cognitive complexity were associated with sustained general internalizing symptoms. We also found that although changes in cognitive complexity had an immediate impact on the well-being of the recently reemployed, only the number of available weekly hours (full-time vs. part-time status) was relevant 6 to 12 weeks later. Our longitudinal model thus provides significant nuance to the current understanding of underemployment and mental health. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Monfort, Samuel S.; Howe, George W.; Nettles, Christopher D.; Weihs, Karen L.
2014-01-01
Underemployed workers—those receiving less pay, working fewer hours, or using fewer skills than they would prefer—appear to experience negative mental health outcomes similar to the unemployed. Prior cross-sectional research provides mixed empirical evidence for this conclusion, however. The current study sought to clarify the impact of underemployment longitudinally, assessing mental health five times over eight months following job loss. In addition to the commonly used indicators of underemployment, we designed a measure of cognitive complexity using the Occupational Information Network (O*NET), an extensive government database used to organize and categorize occupational information. Replicating past research, we found concurrent associations between all indexes of re-employment job quality and internalizing symptoms in the period immediately after re-employment. However, when controlling for quality of prior employment, all indicators except our measure for cognitive complexity became non-significant. As participants transitioned from unemployment to re-employment, only reductions in cognitive complexity were associated with sustained general internalizing symptoms. We also found that although changes in cognitive complexity had an immediate impact on the well-being of the recently re-employed, only the number of available weekly hours (full-time vs. part-time status) was relevant 6-12 weeks later. Our longitudinal model thus provides significant nuance to the current understanding of underemployment and mental health. PMID:25151465
A report on economic studies of Australian mental health issues.
Williams, Ruth; Doessel, Darrel
2006-06-01
To report on economic studies of Australian mental health issues. Although the international literature on the economics of mental health issues is increasing, and although many Australian studies exist on one comorbid condition of mental illness, namely substance abuse, there are very few empirical studies by economists of Australia's mental health issues.
NASA Astrophysics Data System (ADS)
Power, Sarah D.; Falk, Tiago H.; Chau, Tom
2010-04-01
Near-infrared spectroscopy (NIRS) has recently been investigated as a non-invasive brain-computer interface (BCI). In particular, previous research has shown that NIRS signals recorded from the motor cortex during left- and right-hand imagery can be distinguished, providing a basis for a two-choice NIRS-BCI. In this study, we investigated the feasibility of an alternative two-choice NIRS-BCI paradigm based on the classification of prefrontal activity due to two cognitive tasks, specifically mental arithmetic and music imagery. Deploying a dual-wavelength frequency domain near-infrared spectrometer, we interrogated nine sites around the frontopolar locations (International 10-20 System) while ten able-bodied adults performed mental arithmetic and music imagery within a synchronous shape-matching paradigm. With the 18 filtered AC signals, we created task- and subject-specific maximum likelihood classifiers using hidden Markov models. Mental arithmetic and music imagery were classified with an average accuracy of 77.2% ± 7.0 across participants, with all participants significantly exceeding chance accuracies. The results suggest the potential of a two-choice NIRS-BCI based on cognitive rather than motor tasks.
Schwalbe, Craig S; Gearing, Robin E; Mackenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan W
2013-01-01
This study reports the prevalence of emotional and behavioral problems among youths placed in juvenile correctional facilities in Jordan and describes the effect of length of stay on mental health outcomes. The Youth Self Report (YSR) was administered to 187 adolescent males (mean age=16.4, SD=1.0) in all five juvenile detention facilities in Jordan in 2011. Descriptive statistics were calculated to estimate the prevalence of emotional and behavioral problems. Logistic regression models were estimated to evaluate the impact of placement length on mental health. Statistical models were weighted by the youth propensity to be 'long-stay' youths (>23 weeks) based on preplacement case characteristics. The prevalence of clinically significant emotional and behavioral problems was 84%. 46% had YSR scores above the clinical cutpoint in both the internalizing and externalizing subscales. 24% of youths reported suicidal ideation. The high prevalence of emotional and behavioral disorders was stable across placement for most YSR subscales. The prevalence of emotional and behavioral disorders among detained and incarcerated youth in Jordan mirrors the literature worldwide. These findings suggest that serious mental health problems for many youths persist throughout placement. Copyright © 2013 Elsevier Ltd. All rights reserved.
Schuy, Katrin; Brants, Loni M; Dors, Simone; Ströhle, Andreas; Zimmermann, Peter Lutz; Willmund, Gerd Dieter; Rau, Heinrich; Siegel, Stefan
2018-05-14
Mental illness stigma is a barrier to healthcare utilization. This study is the first to research the connection between mental illness stigma and the use of healthcare by veterans of the German Armed Forces. An overview of perceived stigma components in this sample is provided that should help understand how these factors influence healthcare utilization. 43 interviews with veterans of the German Armed Forces were conducted. The resulting data were analyzed in several coding steps. It was investigated whether the stigma experience of veterans of the German Armed Forces could be well illustrated by the theory-based stigmatization model of Link and Phelan. A set of hypotheses on stigma and healthcare utilization based on the data were developed. All stigma components according to the model of Link and Phelan were found in the sample. Internalized stigma, perceived public stigmatization, vocational disadvantage and social exclusion as well as feared misunderstanding of the military past in the civilian sector were reported as main stigma-relevant barriers to the use of healthcare. Recommendations for interventions are given to decrease mental illness stigma in this specific group of former soldiers. © Georg Thieme Verlag KG Stuttgart · New York.
Food Insecurity and Mental Disorders in a National Sample of U.S. Adolescents
McLaughlin, Katie A.; Green, Jennifer Greif; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.
2013-01-01
Objective To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method Data were drawn from 6,483 adolescent–parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture’s Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status). Results Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14%increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation. Conclusions Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health. PMID:23200286
Mental Health From the Perspective of Primary Care Residents: A Pilot Survey
Sharma, Taral; Alishayev, Ilya; Mingoia, Joseph; Vance, John Eric; Ali, Rizwan
2014-01-01
Objective: Primary care physicians are increasingly providing psychiatric care in the United States. Unfortunately, there is limited learning opportunity or exposure to psychiatry during their residency training. This survey was conducted to assess primary care resident interaction with mental health professionals and their satisfaction, knowledge, preference, and comfort with the delivery of mental health care in primary health care settings. Method: On the basis of available published literature, a 20-question survey was formulated. Following receipt of the institutional review board’s approval, these questions were sent via e-mail in February 2012 to internal and family medicine residents (N = 108) at 2 teaching hospitals in southwest Virginia. Analysis of the electronically captured data resulted in a response rate of 32%. Descriptive analysis was used to examine the results. Results: The responses were equally divided among male and female residents and family medicine and internal medicine residents. There were several interesting findings from the survey. No correlations were noted between the gender of residents, type or location of the medical school, or having had a psychiatric rotation during residency and the reported comfort level treating patients with psychiatric illness or the desire to see psychiatric patients in the future. A positive correlation was found between the residents’ training level and their belief about the percentage of mental health providers who have mental health problems. Conclusions: The current training model to acclimate primary care residents to the field of mental health appears to have major limitations. Results of this pilot survey can serve as a guide to conduct prospective, multicenter studies to identify and improve psychiatric training for primary care residency programs. PMID:25664216
Sacheli, Lucia Maria; Zapparoli, Laura; De Santis, Carlo; Preti, Matteo; Pelosi, Catia; Ursino, Nicola; Zerbi, Alberto; Banfi, Giuseppe; Paulesu, Eraldo
2017-10-01
Gait imagery and gait observation can boost the recovery of locomotion dysfunctions; yet, a neurologically justified rationale for their clinical application is lacking as much as a direct comparison of their neural correlates. Using functional magnetic resonance imaging, we measured the neural correlates of explicit motor imagery of gait during observation of in-motion videos shot in a park with a steady cam (Virtual Walking task). In a 2 × 2 factorial design, we assessed the modulatory effect of gait observation and of foot movement execution on the neural correlates of the Virtual Walking task: in half of the trials, the participants were asked to mentally imitate a human model shown while walking along the same route (mental imitation condition); moreover, for half of all the trials, the participants also performed rhythmic ankle dorsiflexion as a proxy for stepping movements. We found that, beyond the areas associated with the execution of lower limb movements (the paracentral lobule, the supplementary motor area, and the cerebellum), gait imagery also recruited dorsal premotor and posterior parietal areas known to contribute to the adaptation of walking patterns to environmental cues. When compared with mental imitation, motor imagery recruited a more extensive network, including a brainstem area compatible with the human mesencephalic locomotor region (MLR). Reduced activation of the MLR in mental imitation indicates that this more visually guided task poses less demand on subcortical structures crucial for internally generated gait patterns. This finding may explain why patients with subcortical degeneration benefit from rehabilitation protocols based on gait observation. Hum Brain Mapp 38:5195-5216, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Food insecurity and mental disorders in a national sample of U.S. adolescents.
McLaughlin, Katie A; Green, Jennifer Greif; Alegría, Margarita; Jane Costello, E; Gruber, Michael J; Sampson, Nancy A; Kessler, Ronald C
2012-12-01
To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture's Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status). Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14% increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation. Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Gallo, Verónica Del Valle; Burrone, María Soledad; Fernandez, Alicia Ruth; Boyd, Jennifer E; Abeldaño, Roberto Ariel
2017-01-01
People who consume psychoactive substances may experience situations of social stigma on the part of the society in general, and also situations of internalized-stigma derived from their own consumption of substances. The Internalized Stigma of Mental Illness (ISMI) scale has been shown to be valid and reliable to evaluate the internalized-stigma in people with severe mental disorders, but in Argentina there is no a Spanish version of this scale for use with people who use psychoactive substances. The objective of this work was to evaluate the psychometric properties of the Spanish version of the Internalized Stigma of Mental Illness instrument adapted for people who use psychoactive substances. The work was carried out on a sample of 200 patients older than 18 years under treatment of rehabilitation by consumption of psychoactive substances in a public institution of the city of Córdoba (Argentina) between the years 2014 and 2016. The instrument used was the Internalized Stigma of Mental Illness (ISMI) previously adapted for use in these groups of patients. It was determined the reliability of the scale through Cronbach's coefficients α and factorial structure was analyzed through an exploratory factor analysis. The obtained coefficients showed a high reliability, while in the factorial structure emerged the 4 theoretical dimensions described by Ritsher, namely: social isolation, perceived discrimination, alienation and stereotyping. It is concluded that the scale adapted for people who use psychoactive substances is reliable and with an adequate factorial structure.
Schmiege, Sarah J; Khoo, Siek Toon; Sandler, Irwin N; Ayers, Tim S; Wolchik, Sharlene A
2006-12-01
The death of a parent is a major family disruption that can place children at risk for later depression and other mental health problems. Theoretically based randomized controlled trial for parentally bereaved children. Two-hundred and forty-four children and adolescents and their caregivers from 156 families were randomly assigned to the Family Bereavement Program (FBP) intervention condition (90 families; 135 children) or to a control condition (66 families; 109 children). Data collection occurred from 1996 to 1998. Children and caregivers in the intervention condition met separately for 12 two-hour weekly sessions. Skills targeted by the program for children included positive coping, stress appraisals, control beliefs, and self-esteem. The caregiver program targeted caregiver mental health, life stressors, and improved discipline in the home. Both child and caregiver programs focused on improved quality of the caregiver-child relationship. Child and caregiver reports of internalizing and externalizing symptoms. Longitudinal growth curve modeling was performed to model symptoms over time from the point of parental death. The rate of recovery for girls in the program condition was significantly different from that of girls in the control condition across all outcomes. Boys in both conditions showed reduced symptoms over time. The methodology offers a conceptually unique way of assessing recovery in terms of reduced mental health problems over time after an event and has contributed to further understanding of FBP intervention effects. The intervention program facilitated recovery among girls, who did not show reduction in behavior problems without the program, while boys demonstrated decreased symptoms even without intervention.
Westrupp, E M; Northam, E; Lee, K J; Scratch, S E; Cameron, F
2015-11-01
Children with type 1 diabetes are at increased risk of mental health problems, which in turn are associated with poor glycemic control, diabetes-related complications, and long-term psychiatric morbidity. We tested the efficacy of the Triple P-Positive Parenting Program in reducing or preventing mental health problems and improving glycemic control in children with type 1 diabetes in a randomized controlled trial. Participants were recruited from the Diabetes Clinic, Royal Children's Hospital, Melbourne, Australia, and randomized to Triple P or standard diabetes care. The primary outcome was child internalizing and externalizing behavior problems 3 and 12 months postrandomization. Secondary outcomes were glycemic control, parent mental health, parenting skills, and family functioning at 3 and 12 months, and glycemic control at 24 months. A total of 76 participants were randomized (38 to intervention and 38 to control), 60 completed 3-month, and 57 completed 12-month assessments. Benefits of Triple P were evident at 3 months for parent mental health, parenting skills, and family functioning (p < 0.05), but not for child mental health or glycemic control, with little effect at 12 months. Prespecified subgroup analyses for children with pre-existing internalizing or externalizing behavior problems indicated greater improvements in child mental health, parent mental health, parenting skills, and diabetes family conflict (p < 0.05), but lower parenting self-efficacy at 3 months. Improvements in parent mental health and parenting competency associated with Triple P were sustained to 12 months for children with pre-existing mental health problems. This study provides some support for the efficacy of Triple P in improving parent and family outcomes, and reducing child internalizing and externalizing behavior problems primarily in children who have pre-existing mental health problems. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Farbstein, Ilana; Mansbach-Kleinfeld, Ivonne; Levinson, Daphna; Goodman, Robert; Levav, Itzhak; Vograft, Itzik; Kanaaneh, Rasim; Ponizovsky, Alexander M; Brent, David A; Apter, Alan
2010-05-01
The development of epidemiological instruments has enabled the assessment of mental disorders in youth in countries that plan policy according to evidence-based principles. The Israel Survey of Mental Health among Adolescents (ISMEHA) was conducted in 2004-2005 in a representative sample of 957 adolescents aged 14-17 and their mothers. The aims of this study were to estimate prevalence rates of internalizing and externalizing mental disorders and their socio-demographic and health correlates. Disorders were ascertained with the Development and Well-Being Assessment inventory and verified by child psychiatrists. The prevalence rates were 11.7%, 8.1% and 4.8% for any disorder, internalizing disorders and externalizing disorders, respectively. Distinct risk factors were associated with the different types of disorders: internalizing disorders were associated with female gender, chronic medical conditions and being cared for by a welfare agency. Risk factors for externalizing disorders were male gender, having divorced or single parents, being an only child or having only one sibling. Learning disability was associated with both types of disorders. The risk and protective factors related to internalizing and externalizing disorders are interpreted within the framework of family composition in this multicultural society.
Rowaert, Sara; Vandevelde, Stijn; Lemmens, Gilbert; Audenaert, Kurt
Mentally ill offenders in Belgium can be subjected to mandated care under an "internment measure" if they are viewed as a danger to society. This study investigated how family members of mentally ill offenders experience this internment measure and view the (forensic) psychiatric treatment of their relative. Semi-structured interviews were conducted with 24 relatives and analysed using Nvivo 11. Six different themes emerged: (1) the criminal offence and the internment measure as an additional stigma, (2) ambivalent feelings towards the judicial system, (3) prison is not the right place to be, (4) mental health support as an answer to problems, (5) fight a losing battle, and (6) while there is life there is hope. The experiences of family members indicate the need for improved treatment guidelines that allow earlier compulsory interventions to prevent crime and preferential admission to (forensic) psychiatric facilities rather than prisons. In addition, family members expressed the need for better communication from mental health professionals and the judicial system during the process and greater availability of peer support. Copyright © 2017 Elsevier Ltd. All rights reserved.
Adler, Jonathan M
2012-02-01
Narrative identity is the internalized, evolving story of the self that each person crafts to provide his or her life with a sense of purpose and unity. A proliferation of empirical research studies focused on narrative identity have explored its relationship with psychological well-being. The present study is the first prospective, multiwave longitudinal investigation to examine short-term personality change via an emphasis on narrative identity as it relates to mental health. Forty-seven adults wrote rich personal narratives prior to beginning psychotherapy and after every session over 12 assessment points while concurrently completing a measure of mental health. Narratives were coded for the themes of agency and coherence, which capture the dual aims of narrative identity: purpose and unity. By applying in-depth thematic coding to the stories of participants, the present study produced 47 case studies of intraindividual personality development and mental health. By employing multilevel modeling with the entire set of nearly 600 narratives, the present study also identified robust trends of individual differences in narrative changes as they related to improvements in mental health. Results indicated that, across participants, the theme of agency, but not coherence, increased over the course of time. In addition, increases in agency were related to improvements in participants' mental health. Finally, lagged growth curve models revealed that changes in the theme of agency occurred prior to the associated improvements in mental health. This finding remained consistent across a variety of individual-difference variables including demographics, personality traits, and ego development.
Raviola, Giuseppe; Eustache, Eddy; Oswald, Catherine; Belkin, Gary S
2012-01-01
Significant challenges exist in providing safe, effective, and culturally sound mental health and psychosocial services when an unforeseen disaster strikes in a low-resource setting. We present here a case study describing the experience of a transnational team in expanding mental health and psychosocial services delivered by two health care organizations, one local (Zanmi Lasante) and one international (Partners in Health), acting collaboratively as part of the emergency response to the 2010 Haiti earthquake. In the year and a half following the earthquake, Zanmi Lasante and Partners in Health provided 20,000 documented individual and group appointments for mental health and psychosocial needs. During the delivery of disaster response services, the collaboration led to the development of a model to guide the expansion and scaling up of community-based mental health services in the Zanmi Lasante health care system over the long-term, with potential for broader scale-up in Haiti. This model identifies key skill packages and implementation rules for developing evidence-based pathways and algorithms for treating common mental disorders. Throughout the collaboration, efforts were made to coordinate planning with multiple organizations interested in supporting the development of mental health programs following the disaster, including national governmental bodies, nongovernmental organizations, universities, foreign academic medical centers, and corporations. The collaborative interventions are framed here in terms of four overarching categories of action: direct service delivery, research, training, and advocacy. This case study exemplifies the role of psychiatrists working in low-resource settings as public health program implementers and as members of multidisciplinary teams.
Katz-Wise, Sabra L; Rosario, Margaret; Calzo, Jerel P; Scherer, Emily A; Sarda, Vishnudas; Austin, S Bryn
2017-07-01
Sexual minorities (mostly heterosexual, bisexual, lesbian/gay) are more likely than heterosexuals to have adverse mental health, which may be related to minority stress. We used longitudinal data from 1461 sexual minority women and men, aged 22-30 years, from Wave 2010 of the Growing Up Today Study, to examine associations between sexual minority stressors and mental health. We hypothesized that sexual minority stressors (earlier timing of sexual orientation developmental milestones categorized into early adolescence, middle adolescence, late adolescence/young adulthood; greater sexual orientation mobility; more bullying victimization) would be positively associated with mental health outcomes (depressive and anxious symptoms). Linear regression models stratified by gender and sexual orientation were fit via generalized estimating equations and controlled for age and race/ethnicity. Models were fit for each stressor predicting each mental health outcome. Reaching sexual minority milestones in early versus middle adolescence was associated with greater depressive and anxious symptoms among lesbians and gay men. Reaching sexual minority milestones in late adolescence/young adulthood versus middle adolescence was associated with greater depressive symptoms among lesbians, but fewer depressive and anxious symptoms among gay men. Greater sexual orientation mobility was associated with greater depressive symptoms among mostly heterosexual women. More bullying victimization was associated with greater depressive symptoms among bisexual women and with greater anxious symptoms among mostly heterosexual women. Sexual minority stressors are associated with adverse mental health among some sexual minority young adults. More research is needed to understand what may be protecting some subgroups from the mental health effects of sexual minority stressors.
Beyer, Thomas; Postert, Christian; Müller, Jörg M; Furniss, Tilman
2012-08-01
In a four-year longitudinal study, changes in and continuity of behavioral and emotional problems were examined in 814 subjects from kindergarten to primary school. Mental health problems were assessed by means of the Child Behavior Checklist (CBCL). The distribution of the CBCL broadband groups revealed a high level of continuity of internalizing symptoms over the four-year period and a shift from externalizing symptoms at baseline towards a combination of internalizing and externalizing symptoms at follow-up. The presence of mental health problems at follow-up was correlated with gender (higher amongst boys), pre-existing mental health problems at baseline, and separation or divorce of the parents, but not with single-family status or the age and educational level of the mother. The increasing number of children with a combination of internalizing and externalizing symptoms demonstrates the increasing complexity of child mental health problems in the developmental span from preschool age to school age.
Report of a mental health survey among Chinese international students at Yale University.
Han, Xuesong; Han, Xuemei; Luo, Qianlai; Jacobs, Selby; Jean-Baptiste, Michel
2013-01-01
To examine the prevalence of depression and anxiety symptoms in Chinese international students, to identify factors that might be associated with these 2 symptom complexes, and to investigate their perception of mental health issues and counseling services. Chinese students (N = 130) at Yale University. Participants completed an anonymous online survey in fall 2009. Forty-five percent reported symptoms of depression, and 29% reported symptoms of anxiety. A self-evaluation of poor current health, a poor relationship with one's advisor, and a low exercise regimen were associated with a higher prevalence of depression and anxiety symptoms. Twenty-seven percent of responders were not aware of the availability of mental health and counseling services on campus. This study suggests that efforts should be made to improve the relationship between students and their advisors and to enhance the awareness of and the accessibility to mental health and counseling services to improve the mental health of Chinese international students.
Competencies for disaster mental health.
King, Richard V; Burkle, Frederick M; Walsh, Lauren E; North, Carol S
2015-03-01
Competencies for disaster mental health are essential to domestic and international disaster response capabilities. Numerous consensus-based competency sets for disaster health workers exist, but no prior study identifies and discusses competency sets pertaining specifically to disaster mental health. Relevant competency sets were identified via MEDLINE, PsycINFO, EBSCO, and Google Scholar searches. Sixteen competency sets are discussed, some providing core competencies for all disaster responders and others for specific responder groups within particular professions or specialties. Competency sets specifically for disaster mental health professionals are lacking, with the exception of one set that focused only on cultural competence. The identified competency sets provide guidance for educators in developing disaster mental health curricula and for disaster health workers seeking education and training in disaster mental health. Valid, criterion-based competencies are required to guide selection and training of mental health professionals for the disaster mental health workforce. In developing these competencies, consideration should be given to the requirements of both domestic and international disaster response efforts.
Livingston, James D; Boyd, Jennifer E
2010-12-01
An expansive body of research has investigated the experiences and adverse consequences of internalized stigma for people with mental illness. This article provides a systematic review and meta-analysis of the extant research regarding the empirical relationship between internalized stigma and a range of sociodemographic, psychosocial, and psychiatric variables for people who live with mental illness. An exhaustive review of the research literature was performed on all articles published in English that assessed a statistical relationship between internalized stigma and at least one other variable for adults who live with mental illness. In total, 127 articles met the inclusion criteria for systematic review, of which, data from 45 articles were extracted for meta-analyses. None of the sociodemographic variables that were included in the study were consistently or strongly correlated with levels of internalized stigma. The review uncovered a striking and robust negative relationship between internalized stigma and a range of psychosocial variables (e.g., hope, self-esteem, and empowerment). Regarding psychiatric variables, internalized stigma was positively associated with psychiatric symptom severity and negatively associated with treatment adherence. The review draws attention to the lack of longitudinal research in this area of study which has inhibited the clinical relevance of findings related to internalized stigma. The study also highlights the need for greater attention on disentangling the true nature of the relationship between internalized stigma and other psychosocial variables. Copyright © 2010 Elsevier Ltd. All rights reserved.
Bai, Sunhye; Repetti, Rena L
2018-04-01
Examining emotion reactivity and recovery following minor problems in daily life can deepen our understanding of how stress affects child mental health. This study assessed children's immediate and delayed emotion responses to daily problems at school, and examined their correlations with psychological symptoms. On 5 consecutive weekdays, 83 fifth graders (M = 10.91 years, SD = 0.53, 51% female) completed brief diary forms 5 times per day, providing repeated ratings of school problems and emotions. They also completed a one-time questionnaire about symptoms of depression, and parents and teachers rated child internalizing and externalizing problems. Using multilevel modeling techniques, we assessed within-person daily associations between school problems and negative and positive emotion at school and again at bedtime. On days when children experienced more school problems, they reported more negative emotion and less positive emotion at school, and at bedtime. There were reliable individual differences in emotion reactivity and recovery. Individual-level indices of emotion responses derived from multilevel models were correlated with child psychological symptoms. Children who showed more negative emotion reactivity reported more depressive symptoms. Multiple informants described fewer internalizing problems among children who showed better recovery by bedtime, even after controlling for children's average levels of exposure to school problems. Diary methods can extend our understanding of the links between daily stress, emotions and child mental health. Recovery following stressful events may be an important target of research and intervention for child internalizing problems.
Friedman, Jack R
2016-04-01
Since the end of Communism, mental health care in Romania has increasingly sought to align its practices with idealized models of Western psychiatric practice. Much of this realignment has been made possible by accessing and integrating new pharmaceuticals into psychiatric hospital settings. Less straightforward have been the painful attempts to create a system modeled on international standards for training and certifying psychotherapists. Unfortunately, the political, economic, infrastructural, and epistemological environment of the Romanian mental health care system has prevented many other reforms. This paper examines the ironic trajectory that Romanian psychiatry has taken since the end of state socialism. Specifically, this paper shows how psychiatric practice in most places (outside of university-training hospitals) is increasingly disconnected from a concern with the social conditions that surround mental illness during a period when social upheaval is profoundly impacting the lives of many people who receive mental health care. Thus, as the contribution of social problems to the suffering of those with mental illnesses has increased, some Romanian mental health practitioners have moved away from a concern with these social problems under the guise of aligning their psychiatric practices with (imagined) Western standards of biomedical care. The paper provides a brief history of Romanian psychiatry and explores contemporary challenges and contradictions in many Romanian psychiatric treatment settings through the case study of a 31-year-old Romanian female diagnosed with paranoid schizophrenia. © The Author(s) 2015.
Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, José Miguel; Cardoso, Graça; King, Michael
2012-01-01
The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these settings may promote service users' autonomy.
Using Children's Literature to Strengthen Social and Emotional Learning
ERIC Educational Resources Information Center
Heath, Melissa Allen; Smith, Kathryn; Young, Ellie L.
2017-01-01
The introductory article to this special edition of "School Psychology International," "Using Children's Literature to Strengthen Social and Emotional Learning," describes the need for a broader base of support for children's mental health needs. Both nationally and internationally, the limited number of mental health…
ERIC Educational Resources Information Center
Tasse, Marc J.
2013-01-01
The World Health Organization (WHO) is in the process of developing the 11th edition of the "International Classification of Diseases" ("ICD-11"). Part of this process includes replacing "mental retardation" with a more acceptable term to identify the condition. The current international consensus appears to be replacing "mental retardation" with…
Child allergic symptoms and mental well-being: the role of maternal anxiety and depression.
Teyhan, Alison; Galobardes, Bruna; Henderson, John
2014-09-01
To determine whether maternal mental health mediates the relationship between eczema or asthma symptoms and mental well-being in children. Analysis of 7250 children from the Avon Longitudinal Study of Parents and Children. Child mental well-being at 8 years was measured by the Strengths and Difficulties Questionnaire. Binary outcomes were high 'internalizing' (anxious/depressive) and 'externalizing' (oppositional/hyperactive) problems (high was >90th percentile). Child rash and wheeze categories were 'none'; 'early onset transient' (infancy/preschool only); 'persistent' (infancy/preschool and at school age); and 'late onset' (school age only). Maternal anxiety and depression were reported during pregnancy and when child was 8 years old. Persistent wheezing symptoms were associated with high externalizing (OR 1.74, 95% CI, 1.41-2.15) and internalizing (1.67, 1.35-2.06) problems compared with never wheeze. Maternal anxiety and depression, and disrupted child sleep, attenuated these associations. Persistent rash (externalizing: 1.74, 1.40-2.15; internalizing: 1.42, 1.16-1.74) and late onset rash (externalizing: 1.62, 1.17-2.25; internalizing: 1.46, 1.07-1.99) symptoms were associated with poorer mental well-being compared with no rash at any age. Maternal anxiety and depression, particularly when child was aged 8 years rather than during pregnancy, accounted for the association with internalizing symptoms and partly for externalizing symptoms. Sleep disruption did not mediate the association. Maternal anxiety and depression may mediate the association between child rash and wheeze and child mental well-being. Copyright © 2014 The Authors. Published by Mosby, Inc. All rights reserved.
Psychological abuse, mental health, and acceptance of dating violence among adolescents
Temple, Jeff R.; Choi, Hye Jeong; Elmquist, JoAnna; Hecht, Michael; Miller-Day, Michelle; Stuart, Gregory L.; Brem, Meagan; Wolford-Clevenger, Caitlin
2016-01-01
Purpose Existing literature indicates that acceptance of dating violence is a significant and robust risk factor for psychological dating abuse perpetration. Past work also indicates a significant relationship between psychological dating abuse perpetration and poor mental health. However, no known research has examined the relationship between acceptance of dating violence, perpetration of dating abuse, and mental health. In addition to exploring this complex relationship, the current study examines whether psychological abuse perpetration mediates the relationship between acceptance of dating violence and mental health (i.e., internalizing symptoms of depression, anxiety, and hostility). Methods Three waves of longitudinal data were obtained from 1,042 ethnically diverse high school students in Texas. Participants completed assessments of psychological dating abuse perpetration, acceptance of dating violence, and internalizing symptoms (hostility, and symptoms of anxiety and depression). Results As predicted, results indicated that perpetration of psychological abuse was significantly associated with acceptance of dating violence and all internalizing symptoms. Furthermore, psychological abuse mediated the relationship between acceptance of dating violence and internalizing symptoms. Conclusions Findings from the current study suggest that acceptance of dating violence is an important target for the prevention of dating violence and related emotional distress. Implications and Contribution Study findings indicate that perpetration of psychological abuse is significantly associated with acceptance of dating violence and select mental health variables (i.e., anxiety, depression, hostility). Moreover, psychological abuse perpetration mediated the relationship between acceptance of dating violence and internalizing symptoms. To be effective in preventing mental health problems, interventions may benefit from targeting acceptance and perpetration of dating violence. PMID:27238840
Physical and Mental Health Disparities among Young Children of Asian Immigrants
Huang, Keng-Yen; Calzada, Esther; Cheng, Sabrina; Brotman, Laurie Miller
2013-01-01
Objective To examine physical and mental health functioning among Asian-American children of US-born and immigrant parents. Study design We used data from the Early Childhood Longitudinal Study-Kindergarten Class of 1998–1999 base-year public data file. The sample was restricted to 7726 Asian and US-born white children. Asian subgroups were created based on parents’ country of birth. Child physical and mental health was assessed based on multiple sources of data and measures. Analyses included multivariate linear and logistic regression. Results After adjusting for demographic and contextual differences, disparities were found for physical and mental health indicators. Children of foreign-born Asian families (from east, southeast, and south Asia) were at greater risk for poor physical health, internalizing problems, and inadequate interpersonal relationships compared with children of US-born white families. Conclusion There is little support for the “model minority” myth with regard to physical and mental health. Evidence of physical and mental health disparities among young Asian-American children and differing risk based on region of origin of immigrant parents suggests the need for culturally informed prevention efforts during early childhood. PMID:21907351
Caldas de Almeida, J M
2013-03-01
Mental health services reforms in Latin America and the Caribbean in the last 20 years have led to a significant improvement of mental health services. They also contributed to the development of new evidence that may help the implementation of future reforms. These advances, however, were clearly insufficient to respond to the huge challenges countries of Latin American and the Caribbean face to improve mental health services. Insufficient funding, one of the most important barriers to mental health services development found in most countries, was related to the absence of a strong consensus among all stakeholders and the weakness of user and family associations. Other barriers were the lack of technical capacity of the coordination unit responsible for development of services in the ministries of health, resistance from professionals towards changing to new models of care and lack of human resources. Transition to democracy in some countries and natural disasters proved to be windows of opportunity for mental health services reform. Facilitating factors included alliance with the human rights defence movement, development of research capacity in Latin American and the Caribbean countries, and international cooperation.
Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Dyson, Margaret; Garland, Ann; Brookman-Frazee, Lauren
2017-10-01
Publicly funded mental health services are critical in caring for children with autism spectrum disorder. Accurate identification of psychiatric comorbidity is necessary for effective mental health treatment. Little is known about psychiatric diagnosis for this population in routine mental health care. This study (1) examined correspondence between psychiatric diagnoses reported by mental health clinicians and those derived from a structured diagnostic interview and (2) identified predictors of agreement between clinician-reported and diagnostic interview-derived diagnoses in a sample of 197 children aged 4-14 years with autism spectrum disorder receiving mental health services. Data were drawn from a randomized effectiveness trial conducted in publicly funded mental health services. Non-autism spectrum disorder diagnoses were assessed using an adapted version of the Mini-International Neuropsychiatric Interview, parent version. Cohen's kappa was calculated to examine agreement between Mini-International Neuropsychiatric Interview, parent version and clinician-reported diagnoses of comorbid conditions. Children met criteria for an average of 2.83 (standard deviation = 1.92) Mini-International Neuropsychiatric Interview, parent version diagnoses. Agreement was poor across all diagnostic categories (κ values: 0.06-0.18). Logistic regression identified child gender and clinical characteristics as significant predictors of agreement for specific diagnoses. Results underscore the need for training mental health clinicians in targeted assessment of specific psychiatric disorders and prioritizing treatment development and testing for specific diagnoses to improve care for children with autism spectrum disorder served in publicly funded mental health settings.
Kidd, Sean A; Madan, Athena; Rallabandi, Susmitha; Cole, Donald C; Muskat, Elisha; Raja, Shoba; Wiljer, David; Aylward, David; McKenzie, Kwame
2016-01-01
In the debate in global mental health about the most effective models for developing and scaling interventions, there have been calls for the development of a more robust literature regarding the "non-specific", science of delivery aspects of interventions that are locally, contextually, and culturally relevant. This study describes a rigorous, exploratory, qualitative examination of the key, non-specific intervention strategies of a diverse group of five internationally-recognized organizations addressing mental illness in middle income countries (MICs). A triangulated approach to inquiry was used with semi-structured interviews conducted with service recipients, service providers and leaders, and key community partners (N = 159). The interview focus was upon processes of implementation and operation. A grounded theory-informed analysis revealed cross cutting themes of: a holistic conceptualization of mental health problems, an intensive application of principles of leverage and creating the social, cultural, and policy "space" within which interventions could be applied and resourced. These findings aligned with key aspects of systems dynamic theory suggesting that it might be a helpful framework in future studies of mental health service implementation in MICs.
An integrative theoretical framework of acculturation and salutogenesis.
Riedel, Jeannette; Wiesmann, Ulrich; Hannich, Hans-Joachim
2011-12-01
During the last two decades, the number of international migrants worldwide has constantly risen. In this context, cross-cultural dimensions of psychological disorders receive increased attention, especially depression, anxiety and post-traumatic stress disorders among the migrant population. In this paper we propose a theoretical framework for the understanding of migrant mental health. This framework combines elements from Berry's acculturation model and Antonovsky's salutogenic theory. The former illustrates the main factors that affect an individual's adaptation in a new cultural context. The term acculturative stress denotes unresolved problems resulting from intercultural contact that cannot be overcome easily by simply adjusting or assimilating. The latter specifies the relationship between culturally associated stress and mental health more distinctive, introducing the concepts of generalized resistance resources and sense of coherence that determine mental health outcomes of migrants during acculturative stress periods. Specifically, we provide an integrative framework of acculturation and salutogenesis that helps to integrate inconsistent findings in the migrant mental health literature. The current paper focuses on the effect of resource factors for positive mental health outcomes in the migrant population and summarises some implications for future research activities.
C, Francisca Pérez; Moessner, Markus; A, María Pía Santelices
2017-03-01
This study examines the relationship between triadic family interactions and preschoolers' attachment representations, or internal working models (IWMs), from a qualitative and dimensional perspective. Individual, relational, and sociocultural variables were evaluated using two different samples. The results showed that triadic family interactions were linked to preschoolers' attachment security levels in both groups, indicating the reliability of the proposed model. © 2017 Michigan Association for Infant Mental Health.
ERIC Educational Resources Information Center
Van Loon, L. M. A.; Van De Ven, M. O. M.; Van Doesum, K. T. M.; Hosman, C. M. H.; Witteman, C. L. M.
2015-01-01
Background: Children of parents with mental illness have an elevated risk of developing a range of mental health and psychosocial problems. Yet many of these children remain mentally healthy. Objective: The present study aimed to get insight into factors that protect these children from developing internalizing and externalizing problems. Methods:…
Husain, Farah; Anderson, Mark; Lopes Cardozo, Barbara; Becknell, Kristin; Blanton, Curtis; Araki, Diane; Vithana, Eeshara Kottegoda
2011-08-03
Nearly 2.7 million individuals worldwide are internally displaced (seeking refuge in secure areas of their own country) annually by armed conflict. Although the psychological impact of war has been well documented, less is known about the mental health symptoms of forced displacement among internally displaced persons. To estimate the prevalence of the most common war-related mental health conditions, symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression, and to assess the association between displacement status and these conditions in postwar Jaffna District, Sri Lanka. Between July and September 2009, a cross-sectional multistage cluster sample survey was conducted among 1517 Jaffna District households including 2 internally displaced persons camps. The response rate was 92% (1448 respondents, 1409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5% (n = 539) were recently resettled, and 68.5% (n = 790) were long-term residents. Bivariable analyses followed by multivariable logistic regression models were performed to determine the association between displacement status and mental health. Symptom criteria of PTSD, anxiety, and depression as measured by the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25. The overall prevalences of symptoms of PTSD, anxiety, and depression were 7.0% (95% confidence interval [CI], 5.1%-9.7%), 32.6% (95% CI, 28.5%-36.9%), and 22.2% (95% CI, 18.2%-26.5%), respectively. Currently displaced participants were more likely to report symptoms of PTSD (odds ratio [OR], 2.71; 95% CI, 1.28-5.73), anxiety (OR, 2.91; 95% CI, 1.89-4.48), and depression (OR, 4.55; 95% CI, 2.47-8.39) compared with long-term residents. Recently resettled residents were more likely to report symptoms of PTSD (OR, 1.96; 95% CI, 1.11-3.47) compared with long-term residents. However, displacement was no longer associated with mental health symptoms after controlling for trauma exposure. Among residents of Jaffna District in Sri Lanka, prevalence of symptoms of war-related mental health conditions was substantial and significantly associated with displacement status and underlying trauma exposure.
Towards reasoning and coordinating action in the mental space.
Mohan, Vishwanathan; Morasso, Pietro
2007-08-01
Unlike a purely reactive system where the motor output is exclusively controlled by the actual sensory input, a cognitive system must be capable of running mental processes which virtually simulate action sequences aimed at achieving a goal. The mental process either attempts to find a feasible course of action compatible with a number of constraints (Internal, Environmental, Task Specific etc) or selects it from a repertoire of previously learned actions, according to the parameters of the task. If neither reasoning process succeeds, a typical backup strategy is to look for a tool that might allow the operator to match all the task constraints. This further necessitates having the capability to alter ones own goal structures to generate sub-goals which must be successfully accomplished in order to achieve the primary goal. In this paper, we introduce a forward/inverse motor control architecture (FMC/IMC) that relaxes an internal model of the overall kinematic chain to a virtual force field applied to the end effector, in the intended direction of movement. This is analogous to the mechanism of coordinating the motion of a wooden marionette by means of attached strings. The relaxation of the FMC/IMC pair provides a general solution for mentally simulating an action of reaching a target position taking into consideration a range of geometric constraints (range of motion in the joint space, internal and external constraints in the workspace) as well as effort-related constraints (range of torque of the actuators, etc.). In case, the forward simulation is successful, the movement is executed; otherwise the residual "error" or measure of inconsistency is taken as a starting point for breaking the action plan into a sequence of sub actions. This process is achieved using a recurrent neural network (RNN) which coordinates the overall reasoning process of framing and issuing goals to the forward inverse models, searching for alternatives tools in solution space and formation of sub-goals based on past context knowledge and present inputs. The RNN + FMC/IMC system is able to successfully reason and coordinate a diverse range of reaching and grasping sequences with/without tools. Using a simple robotic platform (5 DOF Scorbot arm + Stereo vision) we present results of reasoning and coordination of arm/tool movements (real and mental simulation) specifically directed towards solving the classical 2-stick paradigm from animal reasoning at a non linguistic level.
Mental health services commissioning and provision: Lessons from the UK?
Ikkos, G; Sugarman, Ph; Bouras, N
2015-01-01
The commissioning and provision of healthcare, including mental health services, must be consistent with ethical principles - which can be summarised as being "fair", irrespective of the method chosen to deliver care. They must also provide value to both patients and society in general. Value may be defined as the ratio of patient health outcomes to the cost of service across the whole care pathway. Particularly in difficult times, it is essential to keep an open mind as to how this might be best achieved. National and regional policies will necessarily vary as they reflect diverse local histories, cultures, needs and preferences. As systems of commissioning and delivering mental health care vary from country to country, there is the opportunity to learn from others. In the future international comparisons may help identify policies and systems that can work across nations and regions. However a persistent problem is the lack of clear evidence over cost and quality delivered by different local or national models. The best informed economists, when asked about the international evidence do not provide clear answers, stating that it depends how you measure cost and quality, the national governance model and the level of resources. The UK has a centrally managed system funded by general taxation, known as the National Health Service (NHS). Since 2010, the UK's new Coalition* government has responded by further reforming the system of purchasing and providing NHS services - aiming to strengthen choice and competition between providers on the basis of quality and outcomes as well as price. Although the present coalition government's intention is to maintain a tax-funded system, free at the point of delivery, introducing market-style purchasing and provider-side reforms to encompass all of these bring new risks, whilst not pursuing reforms of a system in crisis is also seen to carry risks. Competition might bring efficiency, but may weaken cooperation between providers, and transparency too. On the other hand, it is hard to implement necessary governance and control without worsening bureaucracy and inefficiency. The pursuit of market efficiencies has been particularly contentious in mental health care, where many professionals are defensive about the risks to vulnerable patients and to traditional ways of professional working. Developments and debates in the UK may be instructive for others. We conclude this paper with a set of questions that may help inform debate and evaluation of mental health services internationally.
The Internalized Stigma of Mental Illness (ISMI) scale: validation of the Japanese version.
Tanabe, Yosuke; Hayashi, Kunihiko; Ideno, Yuki
2016-04-29
The present study investigated the reliability and validity of a Japanese version of the Internalized Stigma of Mental Illness (ISMI) scale, designed to assess internalized stigma experienced by people with mental illness. A survey was conducted with 173 outpatients with mental illness who attended psychiatric clinics on a regular basis. A retest was conducted with 51 participants to evaluate the scale's psychometric properties. The alpha coefficient for the overall internal consistency was 0.91, and the coefficients of the individual ISMI subscales ranged from 0.57 to 0.81. The test-retest reliability was r = 0.85 (n = 51, P < 0.01). In terms of criterion-related validity, the Japanese version of the ISMI scale was significantly correlated with the Beck Depression Inventory (r = 0.61, P < 0.01), the Rosenberg Self-Esteem Scale (r = -0.53, P < 0.01), and the Empowerment Scale (r = -0.52, P < 0.01). In addition, factor analyses of the ISMI items demonstrated a four-factor solution for the alienation, stereotype endorsement, discrimination experience, and social withdrawal subscales, with the stigma resistance items excluded. The Japanese version of the ISMI scale demonstrated similar reliability and validity to the original English version. Therefore, the Japanese version of the ISMI scale may be an effective and valid tool to measure internalized stigma among Japanese people who have a mental illness.
Staples, Jennifer M; Neilson, Elizabeth C; Bryan, Amanda E B; George, William H
Transgender people are at elevated risk for nonsuicidal self-injury (NSSI) and suicidal ideation compared to the general population. Transgender (trans) refers to a diverse group of people who experience incongruence between their gender identity and sex assigned at birth. The present study is guided by the minority stress model and the psychological mediation framework, which postulate that sexual minority groups experience elevated stress as a result of anti-minority prejudice, contributing to negative mental health outcomes. This study utilized these theories to investigate the role of internalized transnegativity-internalization of negative societal attitudes about one's trans identity-in the relationships of distal trans stress to suicidal ideation and NSSI. A U.S. national sample of trans adults (N = 237) completed a battery of online measures. Structural equation modeling (SEM) was used to compare models with mediation and moderation effects. Results suggested that internalized transnegativity acts as both a mediator and a moderator in the relationship between distal trans stress and suicidal ideation. Log likelihood comparisons suggested moderation models had the superior fit for these data. Results suggest that clinical interventions should directly target individuals' internalized transnegativity as well as societal-level transnegativity.
Psychological Construction in the OCC Model of Emotion
Clore, Gerald L.; Ortony, Andrew
2014-01-01
This article presents six ideas about the construction of emotion: (a) Emotions are more readily distinguished by the situations they signify than by patterns of bodily responses; (b) emotions emerge from, rather than cause, emotional thoughts, feelings, and expressions; (c) the impact of emotions is constrained by the nature of the situations they represent; (d) in the OCC account (the model proposed by Ortony, Clore, and Collins in 1988), appraisals are psychological aspects of situations that distinguish one emotion from another, rather than triggers that elicit emotions; (e) analyses of the affective lexicon indicate that emotion words refer to internal mental states focused on affect; (f) the modularity of emotion, long sought in biology and behavior, exists as mental schemas for interpreting human experience in story, song, drama, and conversation. PMID:25431620
Development of Mental Health Indicators in Korea
Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon
2012-01-01
Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193
Sessions, Kristen L; Wheeler, Lydia; Shah, Arya; Farrell, Deenah; Agaba, Edwin; Kuule, Yusufu; Merry, Stephen P
2017-11-30
Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues. This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme. Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District. Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area. Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness. Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.
Community Mental Health Services in Latin America for People with Severe Mental Disorders
Minoletti, Alberto; Galea, Sandro; Susser, Ezra
2013-01-01
Mental disorders are highly prevalent in Latin American countries and exact a serious emotional toll, yet investment in public mental health remains insufficient. Most countries of the region have developed national and local initiatives to improve delivery of mental health services over the last 22 years, following the technical leadership of the Pan American Health Organization/World Health Organization (PAHO/WHO). It is especially notable that PAHO/WHO facilitated the development of national policies and plans, as well as local programs, to deliver specialized community care for persons with severe mental disorders. Nevertheless, at present, the majority of Latin American countries maintain a model of services for severe mental disorders based primarily on psychiatric hospitals that consume most of the national mental health budget. To accelerate the pace of change, this article emphasizes the need to develop cross-country regional initiatives that promote mental health service development, focusing on severe mental disorders. As one specific example, the authors describe work with RedeAmericas, which has brought together an interdisciplinary group of international investigators to research regional approaches and train a new generation of leaders in public mental health. More generally, four regional strategies are proposed to complement the work of PAHO/ WHO in Latin America: 1) to develop multi-country studies on community services, 2) to study new strategies and interventions in countries with more advanced mental health services, 3) to strengthen advocacy groups by cross-country interchange, and 4) to develop a network of well-trained leaders to catalyze progress across the region. PMID:25339792
Self-Stigma of Mental Illness Scale – Short Form: Reliability and Validity
Corrigan, Patrick W.; Michaels, Patrick J.; Vega, Eduardo; Gause, Michael; Watson, Amy C.; Rüsch, Nicolas
2012-01-01
The internalization of public stigma by persons with serious mental illnesses may lead to self-stigma, which harms self-esteem, self-efficacy, and empowerment. Previous research has evaluated a hierarchical model that distinguishes among stereotype awareness, agreement, application to self, and harm to self with the 40-item Self-Stigma of Mental Illness Scale (SSMIS). This study addressed SSMIS critiques (too long, contains offensive items that discourages test completion) by strategically omitting half of the original scale’s items. Here we report reliability and validity of the 20-item short form (SSMIS-SF) based on data from three previous studies. Retained items were rated less offensive by a sample of consumers. Results indicated adequate internal consistencies for each subscale. Repeated measures ANOVAs showed subscale means progressively diminished from awareness to harm. In support of its validity, the harm subscale was found to be inversely and significantly related to self-esteem, self-efficacy, empowerment, and hope. After controlling for level of depression, these relationships remained significant with the exception of the relation between empowerment and harm SSMIS-SF subscale. Future research with the SSMIS-SF should evaluate its sensitivity to change and its stability through test-rest reliability. PMID:22578819
Ortega, Alexander N; Goodwin, Renee D; McQuaid, Elizabeth L; Canino, Glorisa
2004-01-01
Previous research documents an association of poor parental mental health with asthma in children. This study aims to determine whether the associations between parental mental health problems and childhood asthma attacks persist after controlling for childhood anxiety and depression and other confounding factors. A community household sample of youth ages 4 to 17 years and their primary caregivers from the US Commonwealth of Puerto Rico was studied to determine the associations between parental mental health and childhood asthma attacks. Regression models that predicted asthma attacks in youth controlled for parental mental health problems, childhood anxiety and depression, zone of residence, and parents' age, education, and perception of poverty. After adjusting for children's depressive and anxiety disorders as well as other important confounders, associations between parental depression, suicide attempts, ataque de nervios, and history of mental health treatment and asthma attacks in offspring, by parental report, persisted. Additionally, the frequency of parental mental health problems was associated with children's asthma attacks. Parents with mental health problems were more likely to report histories of asthma attacks in their children compared with parents without mental health problems in Puerto Rico. These associations were not attributable to internalizing disorders in youth but persisted independent of childhood psychopathology and other confounding factors. Clinicians and researchers should recognize the relations between poor parental mental health and childhood asthma and explore the potential role of family psychosocial and behavioral factors related to the manifestation of the disease.
Wang, J L; Lesage, A; Schmitz, N; Drapeau, A
2008-01-01
[corrected] This analysis estimated the gender-specific associations between work stress, major depression, anxiety disorders and any mental disorder, adjusting for the effects of demographic, socioeconomic, psychological and clinical variables. Data from the Canadian national mental health survey were used to examine the gender-specific relationships between work stress dimensions and mental disorders in the working population (n = 24,277). Mental disorders were assessed using a modified version of the World Mental Health - Composite International Diagnostic Interview. In multivariate analysis, male workers who reported high demand and low control in the workplace were more likely to have had major depression (OR 1.74, 95% CI 1.12 to 2.69) and any depressive or anxiety disorders (OR 1.47, 95% CI 1.05 to 2.04) in the past 12 months. In women, high demand and low control was only associated with having any depressive or anxiety disorder (OR 1.39, 95% CI 1.05 to 1.84). Job insecurity was positively associated with major depression in men but not in women. Imbalance between work and family life was the strongest factor associated with having mental disorders, regardless of gender. Policies improving the work environment may have positive effects on workers' mental health status. Imbalance between work and family life may be a stronger risk factor than work stress for mental disorders. Longitudinal studies incorporating important workplace health research models are needed to delineate causal relationships between work characteristics and mental disorders.
Peer education as a strategy for reducing internalized stigma among depressed older adults.
Conner, Kyaien O; McKinnon, Symone A; Ward, Christine J; Reynolds, Charles F; Brown, Charlotte
2015-06-01
This article examines the mechanisms through which peer educator (PE) intervention targets and reduces internalized stigma. There is substantial evidence that internalized stigma negatively impacts the lives of those suffering with mental health concerns, and has been identified as 1 of the most significant barriers to seeking professional mental health services. There has been a push toward identifying interventions and programs that effectively reduce and mitigate the impact of internalized stigma. Research suggests that contact with other individuals who share a stigmatized condition may be a promising approach to targeting and reducing internalized stigma. However, there is a dearth of research that has identified the mechanism through which this contact impacts internalized stigma. Study participants (n = 19) completed a 3-month PE intervention. Each participant was matched with an older adult with a history of depression currently in recovery who provided psychoeducation, social support, and motivational interviewing. Participants completed a demographic questionnaire, public stigma (PDD), and internalized stigma (Internalized Stigma of Mental Illness, ISMI) scales pre- and post-PE intervention. They further participated in a brief semistructured qualitative interview to attain in-depth information about their perceptions of stigma and of working with a PE. Overall, internalized stigma scores were significantly reduced after participating in the PE intervention. In addition, participants identified 4 mechanisms through which contact with their PE impacted their stigmatized beliefs: age related concerns, shared understanding, improved mental health literacy, and mutual support. This study suggests that PE is a potentially valuable approach toward reducing internalized stigma among older adults with depression. (c) 2015 APA, all rights reserved).
Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie
2018-01-01
Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Main outcome measures Agreement in research priorities on a five-point scale. Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. PMID:29502096
International Directory of Mental Retardation Resources.
ERIC Educational Resources Information Center
Dybwad, Rosemary F., Ed.
The directory lists and describes governmental and voluntary agencies, research, and other resources in the field of mental retardation in foreign countries. The first section, on international organizations, gives names, addresses, names of directors, and one or more paragraphs of description for the United Nations and its specialized agencies,…
ERIC Educational Resources Information Center
Bals, Margrethe; Turi, Anne Lene; Vitterso, Joar; Skre, Ingunn; Kvernmo, Siv
2011-01-01
Through differences in family socialization between indigenous and non-indigenous youth, there may be cultural differences in the impact of family factors on mental health outcome. Using structural equation modelling, this population-based study explored the relationship between symptoms of anxiety and depression and family factors in indigenous…
ERIC Educational Resources Information Center
Troadec, Bertrand; Zarhbouch, Benaissa; Frede, Valerie
2009-01-01
The non-computational brand of cognitivism is based on the premise that performances, including those of children, are generated by mental models or representations, i.e., "internal" resources. The sociocultural approach, on the other hand, regards context, i.e., an "external" resource, as the chief means of elaborating…
Prolonged internal displacement and common mental disorders in Sri Lanka: the COMRAID study.
Siriwardhana, Chesmal; Adikari, Anushka; Pannala, Gayani; Siribaddana, Sisira; Abas, Melanie; Sumathipala, Athula; Stewart, Robert
2013-01-01
Evidence is lacking on the mental health issues of internally displaced persons, particularly where displacement is prolonged. The COMRAID study was carried out in year 2011 as a comprehensive evaluation of Muslims in North-Western Sri Lanka who had been displaced since 1990 due to conflict, to investigate the prevalence and correlates of common mental disorders. A cross-sectional survey was carried out among a randomly selected sample of internally displaced people who had migrated within last 20 years or were born in displacement. The total sample consisted of 450 adults aged 18-65 years selected from 141 settlements. Common mental disorders (CMDs) and post-traumatic stress disorder (PTSD) prevalences were measured using the Patient Health Questionnaire and CIDI sub-scale respectively. The prevalence of any CMD was 18.8%, and prevalence for subtypes was as follows: somatoform disorder 14.0%, anxiety disorder 1.3%, major depression 5.1%, other depressive syndromes 7.3%. PTSD prevalence was 2.4%. The following factors were significantly associated with CMDs: unemployment (odds ratio 2.8, 95% confidence interval 1.6-4.9), widowed or divorced status (4.9, 2.3-10.1) and food insecurity (1.7, 1.0-2.9). This is the first study investigating the mental health impact of prolonged forced displacement in post-conflict Sri Lanka. Findings add new insight in to mental health issues faced by internally displaced persons in Sri Lanka and globally, highlighting the need to explore broader mental health issues of vulnerable populations affected by forced displacement.
Self-Stigma of Mental Illness in High School Youth
ERIC Educational Resources Information Center
Hartman, Leah I.; Michel, Natalie M.; Winter, Ariella; Young, Rebecca E.; Flett, Gordon L.; Goldberg, Joel O.
2013-01-01
Despite the prevalence of mental health problems, society continues to stigmatize and discriminate against people with mental illness and in particular, schizophrenia. Among the negative consequences of stigma, is that some individuals with mental illness internalize negative stereotypes about themselves, referred to as self-stigma, which is…
Eisenman, David; Weine, Stevan; Green, Bonnie; de Jong, Joop; Rayburn, Nadine; Ventevogel, Peter; Keller, Allen; Agani, Ferid
2006-02-01
Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.
The REFINEMENT Glossary of Terms: An International Terminology for Mental Health Systems Assessment.
Montagni, Ilaria; Salvador-Carulla, Luis; Mcdaid, David; Straßmayr, Christa; Endel, Florian; Näätänen, Petri; Kalseth, Jorid; Kalseth, Birgitte; Matosevic, Tihana; Donisi, Valeria; Chevreul, Karine; Prigent, Amélie; Sfectu, Raluca; Pauna, Carmen; Gutiérrez-Colosia, Mencia R; Amaddeo, Francesco; Katschnig, Heinz
2018-03-01
Comparing mental health systems across countries is difficult because of the lack of an agreed upon terminology covering services and related financing issues. Within the European Union project REFINEMENT, international mental health care experts applied an innovative mixed "top-down" and "bottom-up" approach following a multistep design thinking strategy to compile a glossary on mental health systems, using local services as pilots. The final REFINEMENT glossary consisted of 432 terms related to service provision, service utilisation, quality of care and financing. The aim of this study was to describe the iterative process and methodology of developing this glossary.
Matson, Michael L; Matso, Johnny L; Lott, Julia D; Logan, James R
2002-01-01
This article is a reflection of international publication trends across prominent journals in the field of mental retardation. Journals reviewed were the Journal of Applied Behavior Analysis, Journal of Intellectual Disability Research, Mental Retardation, and Research in Developmental Disabilities. Percentage of authors from the United States (US) and other countries were evaluated. US authors represented 84-91% in US journals, while US representation in foreign journals was much lower at 21%. The implications of these findings are discussed.
Hospital care for mental health and substance abuse conditions in Parkinson's disease.
Willis, Allison W; Thibault, Dylan P; Schmidt, Peter N; Dorsey, E Ray; Weintraub, Daniel
2016-12-01
The objective of this study was to examine mental health conditions among hospitalized individuals with Parkinson's disease in the United States. This was a serial cross-sectional study of hospitalizations of individuals aged ≥60 identified in the Nationwide Inpatient Sample dataset from 2000 to 2010. We identified all hospitalizations with a diagnosis of PD, alcohol abuse, anxiety, bipolar disorder, depression, impulse control disorders, mania, psychosis, substance abuse, and attempted suicide/suicidal ideation. National estimates of each mental health condition were compared between hospitalized individuals with and without PD. Hierarchical logistic regression models determined which inpatient mental health diagnoses were associated with PD, adjusting for demographic, payer, geographic, and hospital characteristics. We identified 3,918,703 mental health and substance abuse hospitalizations. Of these, 2.8% (n = 104, 437) involved a person also diagnosed with PD. The majority of mental health and substance abuse patients were white (86.9% of PD vs 83.3% of non-PD). Women were more common than men in both groups (male:female prevalence ratio, PD: 0.78, 0.78-0.79, non-PD: 0.58, 0.57-0.58). Depression (adjusted odds ratio 1.32, 1.31-1.34), psychosis (adjusted odds ratio 1.25, 1.15-1.33), bipolar disorder (adjusted odds ratio 2.74, 2.69-2.79), impulse control disorders (adjusted odds ratio 1.51, 1.31-1.75), and mania (adjusted odds ratio 1.43, 1.18-1.74) were more likely among PD patients, alcohol abuse was less likely (adjusted odds ratio 0.26, 0.25-0.27). We found no PD-associated difference in suicide-related care. PD patients have unique patterns of acute care for mental health and substance abuse. Research is needed to guide PD treatment in individuals with pre-existing psychiatric illnesses, determine cross provider reliability of psychiatric diagnoses in PD patients, and inform efforts to improve psychiatric outcomes. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.
Kaminer, Debra; Eagle, Gillian; Crawford-Browne, Sarah
2018-07-01
This article discusses the condition of continuous traumatic stress as common on the African continent and in other international settings characterised by very high levels of ongoing violence and threat of community, political or war-related origin. Through consideration of three case studies from South Africa, contexts of continuous traumatic stress are described, and the mental health and physical health effects of living in such contexts are elaborated. Cautions are raised about attempting to transpose existing posttraumatic stress models onto individuals exposed to situations of continuous traumatic stress, and guidelines for optimal interventions with such cases are proposed.
Trial-by-trial adaptation of movements during mental practice under force field.
Anwar, Muhammad Nabeel; Khan, Salman Hameed
2013-01-01
Human nervous system tries to minimize the effect of any external perturbing force by bringing modifications in the internal model. These modifications affect the subsequent motor commands generated by the nervous system. Adaptive compensation along with the appropriate modifications of internal model helps in reducing human movement errors. In the current study, we studied how motor imagery influences trial-to-trial learning in a robot-based adaptation task. Two groups of subjects performed reaching movements with or without motor imagery in a velocity-dependent force field. The results show that reaching movements performed with motor imagery have relatively a more focused generalization pattern and a higher learning rate in training direction.
Brown-Johnson, Cati G; Cataldo, Janine K; Orozco, Nicholas; Lisha, Nadra E; Hickman, Norval J; Prochaska, Judith J
2015-08-01
De-normalization of smoking as a public health strategy may create shame and isolation in vulnerable groups unable to quit. To examine the nature and impact of smoking stigma, we developed the Internalized Stigma of Smoking Inventory (ISSI), tested its validity and reliability, and explored factors that may contribute to smoking stigma. We evaluated the ISSI in a sample of smokers with mental health diagnoses (N = 956), using exploratory and confirmatory factor analysis, and assessed construct validity. Results reduced the ISSI to eight items with three subscales: smoking self-stigma related to shame, felt stigma related to social isolation, and discrimination experiences. Discrimination was the most commonly endorsed of the three subscales. A multivariate generalized linear model predicted 21-30% of the variance in the smoking stigma subscales. Self-stigma was greatest among those intending to quit; felt stigma was highest among those experiencing stigma in other domains, namely ethnicity and mental illness-based; and smoking-related discrimination was highest among women, Caucasians, and those with more education. Smoking stigma may compound stigma experiences in other areas. Aspects of smoking stigma in the domains of shame, isolation, and discrimination were related to modeled stigma responses, particularly readiness to quit and cigarette addiction, and were found to be more salient for groups where tobacco use is least prevalent. The ISSI measure is useful for quantifying smoking-related stigma in multiple domains. © American Academy of Addiction Psychiatry.
Rodriguez-Seijas, Craig; Stohl, Malki; Hasin, Deborah S; Eaton, Nicholas R
2015-07-01
Multivariable comorbidity research indicates that many common mental disorders are manifestations of 2 latent transdiagnostic factors, internalizing and externalizing. Environmental stressors are known to increase the risk for experiencing particular mental disorders, but their relationships with transdiagnostic disorder constructs are unknown. The present study investigated one such stressor, perceived racial discrimination, which is robustly associated with a variety of mental disorders. To examine the direct and indirect associations between perceived racial discrimination and common forms of psychopathology. Quantitative analysis of 12 common diagnoses that were previously assessed in a nationally representative sample (N = 5191) of African American and Afro-Caribbean adults in the United States, taken from the National Survey of American Life, and used to test the possibility that transdiagnostic factors mediate the effects of discrimination on disorders. The data were obtained from February 2001 to March 2003. Latent variable measurement models, including factor analysis, and indirect effect models were used in the study. Mental health diagnoses from reliable and valid structured interviews and perceived race-based discrimination. While perceived discrimination was positively associated with all examined forms of psychopathology and substance use disorders, latent variable indirect effects modeling revealed that almost all of these associations were significantly mediated by the transdiagnostic factors. For social anxiety disorder and attention-deficit/hyperactivity disorder, complete mediation was found. The pathways linking perceived discrimination to psychiatric disorders were not direct but indirect (via transdiagnostic factors). Therefore, perceived discrimination may be associated with risk for myriad psychiatric disorders due to its association with transdiagnostic factors.
Report of a Mental Health Survey among Chinese International Students at Yale University
ERIC Educational Resources Information Center
Han, Xuesong; Han, Xuemei; Luo, Qianlai; Jacobs, Selby; Jean-Baptiste, Michel
2013-01-01
Objective: To examine the prevalence of depression and anxiety symptoms in Chinese international students, to identify factors that might be associated with these 2 symptom complexes, and to investigate their perception of mental health issues and counseling services. Participants: Chinese students ("N" = 130) at Yale University.…
ERIC Educational Resources Information Center
Sánchez, Jennifer; Rosenthal, David A.; Chan, Fong; Brooks, Jessica; Bezyak, Jill L.
2016-01-01
Purpose: To examine the World Health Organization "International Classification of Functioning, Disability and Health" (ICF) constructs as correlates of community participation of people with severe mental illnesses (SMI). Methods: Quantitative descriptive research design using multiple regression and correlational techniques was used to…
International Summit on Prevention of Mental Retardation from Biomedical Causes.
ERIC Educational Resources Information Center
Koch, Jean, Ed.
Proceedings from the International Summit on Prevention of Mental Retardation from Biomedical Causes are provided. After a list of participants and summary of the highlights of the conference, the keynote address by H. Moser is presented. The following 13 papers are provided along with workshop recommendations and a list of main points elicited…
ERIC Educational Resources Information Center
Atri, Ashutosh; Matorin, Anu; Ruiz, Pedro
2011-01-01
Objective: The authors investigated whether social support and acculturation could predict the mental health of international medical graduates pursuing psychiatric residencies in the United States. Methods: A 55-item online survey was assembled by combining three validated instruments for mental health, social support, and acculturation. A link…
ERIC Educational Resources Information Center
Mahmoud, Sahar; Zaki, Rania A.
2015-01-01
This study was a comparative study aiming to assess the extent of internalized stigma of mental illness among patients with schizophrenia & identify stigma as perceived by family members caring schizophrenic patients. The study was conducted in two settings 1st clinic was outpatient clinic for psychiatric patient affiliated to Abbasia…
Schrimshaw, Eric W; Siegel, Karolynn; Downing, Martin J; Parsons, Jeffrey T
2013-02-01
Although bisexual men report lower levels of mental health relative to gay men, few studies have examined the factors that contribute to bisexual men's mental health. Bisexual men are less likely to disclose, and more likely to conceal (i.e., a desire to hide), their sexual orientation than gay men. Theory suggests that this may adversely impact their mental health. This report examined the factors associated with disclosure and with concealment of sexual orientation, the association of disclosure and concealment with mental health, and the potential mediators (i.e., internalized homophobia, social support) of this association with mental health. An ethnically diverse sample of 203 non-gay-identified, behaviorally bisexual men who do not disclose their same-sex behavior to their female partners were recruited in New York City to complete a single set of self-report measures. Concealment was associated with higher income, a heterosexual identification, living with a wife or girlfriend, more frequent sex with women, and less frequent sex with men. Greater concealment, but not disclosure to friends and family, was significantly associated with lower levels of mental health. Multiple mediation analyses revealed that both internalized homophobia and general emotional support significantly mediated the association between concealment and mental health. The findings demonstrate that concealment and disclosure are independent constructs among bisexual men. Further, they suggest that interventions addressing concerns about concealment, emotional support, and internalized homophobia may be more beneficial for increasing the mental health of bisexual men than those focused on promoting disclosure.
Schrimshaw, Eric W.; Siegel, Karolynn; Downing, Martin J.; Parsons, Jeffrey T.
2013-01-01
Objective Although bisexual men report lower levels of mental health relative to gay men, few studies have examined the factors that contribute to bisexual men’s mental health. Bisexual men are less likely to disclose, and more likely to conceal (i.e., a desire to hide), their sexual orientation than gay men. Theory suggests that this may adversely impact their mental health. This report examined the factors associated with disclosure and with concealment of sexual orientation, the association of disclosure and concealment with mental health, and the potential mediators (i.e., internalized homophobia, social support) of this association with mental health. Method An ethnically-diverse sample of 203 non-gay-identified, behaviorally-bisexual men who do not disclose their same-sex behavior to their female partners were recruited in New York City to complete a single set of self-report measures. Results Concealment was associated with higher income, a heterosexual identification, living with a wife or girlfriend, more frequent sex with women, and less frequent sex with men. Greater concealment, but not disclosure to friends and family, was significantly associated with lower levels of mental health. Multiple mediation analyses revealed that both internalized homophobia and general emotional support significantly mediated the association between concealment and mental health. Conclusions The findings demonstrate that concealment and disclosure are independent constructs among bisexual men. Further, they suggest that interventions addressing concerns about concealment, emotional support, and internalized homophobia may be more beneficial for increasing the mental health of bisexual men than those focused on promoting disclosure. PMID:23276123
Temporal comorbidity of mental disorder and ulcerative colitis.
Cawthorpe, David; Davidson, Marta
2015-01-01
Ulcerative colitis is an inflammatory bowel disease that rarely exists in isolation in affected patients. We examined the association of ulcerative colitis and International Classification of Diseases mental disorder, as well as the temporal comorbidity of three broad International Classification of Diseases groupings of mental disorders in patients with ulcerative colitis to determine if mental disorder is more likely to occur before or after ulcerative colitis. We used physician diagnoses from the regional health zone of Calgary, Alberta, for patient visits from fiscal years 1994 to 2009 for treatment of any presenting concern in that Calgary health zone (763,449 patients) to identify 5113 patients age younger than 1 year to age 92 years (2120 males, average age = 47 years; 2993 females, average age = 48 years) with a diagnosis of ulcerative colitis. The 16-year cumulative prevalence of ulcerative colitis was 0.0058%, or 58 cases per 10,000 persons (95% confidence interval = 56-60 per 10,000). Although the cumulative prevalence of mental disorder in the overall sample was 5390 per 10,000 (53.9%), we found that 4192 patients with ulcerative colitis (82%) also had a diagnosis of a mental disorder. By annual rate of ulcerative colitis, patients with mental disorder had a significantly higher annual prevalence. The mental disorder grouping neuroses/depressive disorders was most likely to arise before ulcerative colitis (odds ratio = 1.87 for males; 2.24 for females). A temporal association was observed between specific groups of International Classification of Diseases mental disorder and ulcerative colitis, indicating a possible etiologic relationship between the disorders or their treatments, or both.
International military operations and mental health--A review.
Kaikkonen, Noora M; Laukkala, Tanja
2016-01-01
Volunteering in international military missions has been scrutinized for its effects on mental health. Different kinds of exposures to traumatic events are associated with a variety of mental disorders, mainly heightened rates of post-traumatic stress disorder (PTSD) and alcohol abuse. Based on the literature we discuss risk and protective factors concerning the psychological well-being of soldiers attending to international military operations. A systematic literature search was carried out using relevant search terms to identify the articles for this review. The ability to recognize and treat acute stress reactions during deployments is important. Post-deployment psychosocial support and services have a role in lowering barriers to care, diminishing stigma and also in recognizing individuals who suffer from psychological distress or psychiatric symptoms, to connect them with appropriate care. Further investigation of gender differences and the role of stigmatization is warranted. Most of those participating in international military operations are repatriated without problems, but repeated exposure to combat situations and other stressors may affect mental health in various ways. Stigmatization is still a barrier to care.
Atopic conditions and mental health problems: a 3-year follow-up study.
Lien, Lars; Green, Kristian; Thoresen, Magne; Bjertness, Espen
2010-09-01
The aim of this study was to test the hypothesis that atopic conditions at 15/16 years of age affect both internalized and externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings. A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires at baseline and follow-up. Hopkins Symptoms Checklist (HSCL-10) was used to assess internalized problems, and two subscales (conduct problems and hyperactivity) from the Strength and Difficulties Questionnaire to measure externalized mental health problems. The atopic conditions investigated were asthma, hay fever and eczema by asking the adolescents whether these conditions were present or not. There was an increase in the prevalence of internalized mental health problems from about 17-25% and a decrease in externalized mental health problems and number of atopic conditions in the follow-up period. Of the atopic conditions, hay fever was most prevalent with about 34% at 15 years of age and 20% at 18. The asthma prevalence was at 10 and 5% and eczema at 25 and 10%, respectively. Internalized mental health problems among girls were significantly associated with atopic conditions 3 years earlier, also after controlling for confounding variables. To live with atopic conditions seem to affect the mood and level of anxiety among adolescent girls. This should be kept in mind by health professionals treating young girls with atopic conditions.
The City MISS: development of a scale to measure stigma of perinatal mental illness.
Moore, Donna; Ayers, Susan; Drey, Nicholas
2017-07-01
This study aimed to develop and validate a scale to measure perceived stigma for perinatal mental illness in women. Stigma is one of the most frequently cited barriers to seeking treatment and many women with perinatal mental illness fail to get the treatment they need. However, there is no psychometric scale that measures how women may experience the unique aspects of perinatal mental illness stigma. A draft scale of 30 items was developed from a literature review. Women with perinatal mental illness (n = 279) were recruited to complete the City Mental Illness Stigma Scale. Concurrent validity was measured using the Internalised Stigma of Mental Illness Scale. Factor analysis was used to create the final scale. The final 15-item City Mental Illness Stigma Scale has a three-factor structure: perceived external stigma, internal stigma and disclosure stigma. The scale accounted for 54% of the variance and had good internal reliability and concurrent validity. The City Mental Illness Stigma Scale appears to be a valid measure which provides a potentially useful tool for clinical practice and research in stigma and perinatal mental illness, including assessing the prevalence and characteristics of stigma. This research can be used to inform interventions to reduce or address the stigma experienced by some women with perinatal mental illness.
Mental health system in Saudi Arabia: an overview
Qureshi, Naseem Akhtar; Al-Habeeb, Abdulhameed Abdullah; Koenig, Harold G
2013-01-01
Background There is evidence that mapping mental health systems (MHSs) helps in planning and developing mental health care services for users, families, and other caregivers. The General Administration of Mental Health and Social Services of the Ministry of Health over the past 4 years has sought to streamline the delivery of mental health care services to health consumers in Saudi Arabia. Objective We overview here the outcome of a survey that assessed the Saudi MHS and suggest strategic steps for its further improvement. Method The World Health Organization Assessment Instrument for Mental Health Systems was used systematically to collect information on the Saudi MHS in 2009–2010, 4 years after a baseline assessment. Results Several mental health care milestones, especially provision of inpatient mental health services supported by a ratified Mental Health Act, were achieved during this period. However, community mental health care services are needed to match international trends evident in developed countries. Similarly, a larger well-trained mental health workforce is needed at all levels to meet the ever-increasing demand of Saudi society. Conclusion This updated MHS information, discussed in light of international data, will help guide further development of the MHS in Saudi Arabia in the future, and other countries in the Eastern Mediterranean region may also benefit from Saudi experience. PMID:23966783
ERIC Educational Resources Information Center
Cherry, Ralph, Comp.
Designed to acquaint social workers and other professionals in the mental health field with the basic terms necessary for professional discussions, paper presentations, and international correspondence, the English/Spanish-Spanish/English glossary lists 130 selected mental health terms. The glossary includes two sections: English to Spanish and…
ERIC Educational Resources Information Center
Kenny, Dianna T.; Lennings, Christopher J.; Nelson, Paul K.
2007-01-01
Young offenders internationally have a higher incidence of mental health problems compared with adolescents in the general population. Mental health issues, particularly comorbid presentations, affect the response to and outcome of rehabilitation and hence recidivism of offending. Most information on the mental health of young offenders has…
The Role of Gesture in Supporting Mental Representations: The Case of Mental Abacus Arithmetic
ERIC Educational Resources Information Center
Brooks, Neon B.; Barner, David; Frank, Michael; Goldin-Meadow, Susan
2018-01-01
People frequently gesture when problem-solving, particularly on tasks that require spatial transformation. Gesture often facilitates task performance by interacting with internal mental representations, but how this process works is not well understood. We investigated this question by exploring the case of mental abacus (MA), a technique in which…
Purpose-in-Life Test: Comparison of the Main Models in Patients with Mental Disorders.
García-Alandete, Joaquín; Marco, José H; Pérez, Sandra
2017-06-27
The aim of this study was to compare the main proposed models for the Purpose-In-Life Test, a scale for assessing meaning in life, in 229 Spanish patients with mental disorders (195 females and 34 males, aged 13-68, M = 34.43, SD = 12.19). Confirmatory factor-analytic procedures showed that the original model of the Purpose-In-Life Test, a 20-item unidimensional scale, obtained a better fit than the other analyzed models, SBχ2(df) = 326.27(170), SBχ2/df = 1.92, TLI = .93, CFI = .94, IFI = .94, RMSEA = .063 (90% CI [.053, .074]), CAIC = -767.46, as well as a high internal consistency, (α = .90). The main conclusion is that the original version of the Purpose-In-Life shows a robust construct validity in a clinical population. However, authors recommend an in-depth psychometric analysis of the Purpose-In-Life Test among clinical population. Likewise, the importance of assessing meaning in life in order to enhance psychotherapeutic treatment is noted.
Post-partum blues among Korean mothers: a structural equation modelling approach.
Chung, Sung Suk; Yoo, Il Young; Joung, Kyoung Hwa
2013-08-01
The objective of this study was to propose the post-partum blues (PPB) model and to estimate the effects of self-esteem, social support, antenatal depression, and stressful events during pregnancy on PPB. Data were collected from 249 women post-partum during their stay in the maternity units of three hospitals in Korea using a self-administered questionnaire. A structural equation modelling approach using the Analysis of Moments Structure program was used to identify the direct and indirect effects of the variables on PPB. The full model had a good fit and accounted for 70.3% of the variance of PPB. Antenatal depression and stressful events during pregnancy had strong direct effects on PPB. Household income showed indirect effects on PPB via self-esteem and antenatal depression. Social support indirectly affected PPB via self-esteem, antenatal depression, and stressful events during pregnancy. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Bouvet, C; Battin, C; Le Roy-Hatala, C
2015-12-01
The aim of this article is 1) to present the Clubhouse (CH) Model and the first French CH, and 2) study the empirical background on the efficiency of the CH concerning employment, quality of life and hospitalization for people with mental illness. The first Clubhouse was created sixty years ago in the U.S. The Clubhouse model of psychosocial rehabilitation is a program that offers to people with mental illness support and opportunities to find a job and return to a normal social life. The Clubhouse model has been built over the years thanks to the experiences of members and staff. It is based on "36 standards" (rules which each Clubhouse follows in order to attain its goals). Supported by associations and families of people with mental illness, health professionals, and the international federation of Clubhouses (Clubhouse International), the first Clubhouse in France has opened in November 2011. This non-medicalized association and its co-management by both members and staff are innovative in France. The aims of the Clubhouse are founded on the concept of empowerment and "peer-help", and on the fight against isolation and stigmatization. Clubhouses offer day-programs which allow people with mental illness to have a sense of community and a useful purpose within the association. Indeed, the salaried management team is voluntarily understaffed so that the participation of members is necessary and so that they can benefit from the opportunities for useful activity within the Clubhouse, developing a real opportunity of empowerment. In order to study the efficiency of CH, we conducted a systematic review of publications on CH, first in the database of Club House International (500 publications) and second, in the scientific data base (Psycinfo, Psycarticles, Academic Search Premier, Medline et Science Direct) (205 publications included in the 500). We identified 64 scientific studies. We have selected 28 of them that focused on the variable: employment, quality of life and hospitalisation. Clubhouses have shown their effectiveness regarding employment, quality of life and hospitalization. Indeed, several studies compare Clubhouses with other programs of psychosocial rehabilitation. The results have demonstrated that Clubhouses' members: find more salaried work, find jobs of higher quality, have a better quality of life and face fewer hospitalizations, than people in other psychosocial rehabilitation programs. We discuss the interest of the CH in France using the experiment of the CH in Paris. This experiment in providing an innovative place of support, mutual aid, and autonomy is currently successful in France. Over 18 months, a team of 65 members and 3 staff members has come together. This enthusiasm is probably due to the fact that the Clubhouse in Paris is a place which helps people with mental illness establish a daily rhythm, social usefulness and affective links, all essential for recovery, in a context different from the usual medically supervised care in other settings: people are treated as individuals rather than as "sick persons" or "patients". This article discusses the benefits of this new model of psychosocial rehabilitation in France, by presenting the originality and complimentarity of this concept, in comparison with other health structures. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
Hassija, Christina M; Jakupcak, Matthew; Maguen, Shira; Shipherd, Jillian C
2012-04-01
The present study evaluated the impact of combat and interpersonal trauma exposure in a sample of 115 U.S. women veterans from Gulf War I and the Iraq and Afghanistan wars on 3 postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Patients presenting for healthcare services at a Veterans Affairs postdeployment health specialty clinic completed screening questionnaires that assessed combat exposure, lifetime interpersonal trauma history of childhood neglect, physical, or sexual abuse, and adult sexual and physical assault. In a regression model, combat exposure was the only significant independent variable associated with PSS, DSS, and alcohol misuse (β = .42, .27 and B = 1.58, respectively) even after adding lifetime interpersonal assault exposure to the model. Results highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Incorporating combat exposure into routine screening procedures for Gulf War and Iraq and Afghanistan war women veterans can aid in mental health treatment planning. Copyright © 2012 International Society for Traumatic Stress Studies.
Mental health service use among South Africans for mood, anxiety and substance use disorders.
Seedat, Soraya; Williams, David R; Herman, Allen A; Moomal, Hashim; Williams, Stacey L; Jackson, Pamela B; Myer, Landon; Stein, Dan J
2009-05-01
Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans. A nationally representative survey of 4351 adults. Twelve-month DSM-IV (Diagnostic and Statistical Manual, 4th edition) diagnoses, severity, and service utilisation were determined using the World Health Organization Composite International Diagnostic Interview (CIDI). Twelve-month treatment was categorised by sector and province. South Africans in households and hostel quarters were interviewed between 2002 and 2004 in all nine provinces. 4 317 respondents 18 years and older were analysed. Bivariate logistic regression models predicted (i) 12-month treatment use of service sectors by gender, and (ii) 12-month treatment use by race by gender. Of respondents with a mental disorder, 25.2% had sought treatment within the previous 12 months; 5.7% had used any formal mental health service. Mental health service use was highest for adults with mood and anxiety disorders, and among those with a mental disorder it varied by province, from 11.4% (Western Cape) to 2.2% (Mpumalanga). More women received treatment, and this was largely attributable to higher rates of treatment in women with mood disorders. Age, income, education and marital status were not significantly associated with mental health service use. Race was associated with the treatment sector accessed in those with a mental disorder. There is a substantial burden of untreated mental disorders in the South African population, across all provinces and even in those with substantial impairment. Greater allocation of resources to mental health services and more community awareness initiatives are needed to address the unmet need.
ERIC Educational Resources Information Center
Miller, Thomas W., Ed.
Clinical theory and practice models are provided along with current concepts in diagnosis and treatment. Theoretical formulations, hypotheses, issues, and implications related to life stress measurement are addressed and applied to medical and mental health concerns. Contributions include: (1) "Stress Response and Adaptation in Children:…
What can philosophy do for psychiatry?
Fulford, Kenneth WM; Stanghellini, Giovanni; Broome, Matthew
2004-01-01
This article illustrates the practical impact of recent developments in the philosophy of psychiatry in five key areas: patient-centred practice, new models of service delivery, neuroscience research, psychiatric education, and the organisation of psychiatry as an international science-led discipline focused on patient care. We conclude with a note on the role of philosophy in countering the stigmatisation of mental disorder. PMID:16633476
Sutton, Keith P; Maybery, Darryl; Moore, Terry
2011-01-01
The Gippsland region of Victoria, in common with other Australian rural and regional areas, is experiencing a shortage of qualified mental health professionals. Attracting mental health professionals to work in such areas is a major concern for service providers, policy-makers and rural/regional communities. Previous studies have focused on identifying factors contributing to the maldistribution of the health workforce, principally medical practitioners. Recent reviews have highlighted the strengths and weaknesses of evidence for the effectiveness of initiatives designed to address workforce shortages in underserved locations. The reported study sought the views of mental health organisation leaders from Gippsland to identify current approaches and potential solutions to the challenges of workforce recruitment, retention and training. A key goal of the study was to inform a strategic regional approach to the development of a more sustainable and effective mental health workforce. Investigators conducted semi-structured individual interviews with 26 administrators, managers and senior clinicians from public and private sector mental health organisations throughout Gippsland. Thematic content analysis of the transcribed interviews identified current approaches and potential solutions to the recruiting, retaining and training problems in the region. The study categorised solutions as focusing on factors external or internal to organisations. Solutions external to organisations included efforts to enhance the pool of available workers, improve intra-sectoral collaboration and cross-sectoral linkages, make funding more flexible, and to institute a contemporary curriculum and take innovative pedagogical approaches to training. Internal solutions included the need for strong leadership and quality organisational culture, flexible and adaptable approaches to meeting individual worker and community needs, promoting the organisation and local area and adopting models of care. Informants indicated that individual organisations are limited in their capacity to address recruitment, retention and training issues and highlighted the potential benefits of a regional mental health workforce recruitment, retention and training strategy. This study provides a unique insight into the creative approaches adopted by managers in Gippsland to recruit and retain mental health workers. It brings a new perspective to the literature due to the reflections of managers, grounded as they are in day-to-day work.
Associations between DSM-IV mental disorders and subsequent non-fatal, self-reported stroke.
Swain, Nicola R; Lim, Carmen C W; Levinson, Daphna; Fiestas, Fabian; de Girolamo, Giovanni; Moskalewicz, Jacek; Lepine, Jean-Pierre; Posada-Villa, Jose; Haro, Josep Maria; Medina-Mora, María Elena; Xavier, Miguel; Iwata, Noboru; de Jonge, Peter; Bruffaerts, Ronny; O'Neill, Siobhan; Kessler, Ron C; Scott, Kate M
2015-08-01
To examine the associations between a wide range of mental disorders and subsequent onset of stroke. Lifecourse timing of stroke was examined using retrospectively reconstructed data from cross-sectional surveys. Data from the World Mental Health Surveys were accessed. This data was collected from general population surveys over 17 countries of 87,250 adults. The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of DSM-IV mental disorders. A weighted subsample (n=45,288), was used for analysis in the present study. Survival analyses estimated associations between first onset of mental disorders and subsequent stroke onset. Bivariate models showed that 12/16 mental disorders were associated with subsequent stroke onset (ORs ranging from 1.6 to 3.8). However, after adjustment for mental disorder comorbidity and smoking, only significant relationships between depression and stroke (OR 1.3) and alcohol abuse and stroke (OR 1.5) remained. Among females, having a bipolar disorder was also associated with increased stroke incidence (OR 2.1). Increasing number of mental disorders was associated with stroke onset in a dose-response fashion (OR 3.3 for 5+ disorders). Depression and alcohol abuse may have specific associations with incidence of non-fatal stroke. General severity of psychopathology may be a more important predictor of non-fatal stroke onset. Mental health treatment should be considered as part of stroke risk prevention. Limitations of retrospectively gathered cross sectional surveys design mean further research on the links between mental health and stroke incidence is warranted. Copyright © 2015 Elsevier Inc. All rights reserved.
REVIEW: Widespread access to predictive models in the motor system: a short review
NASA Astrophysics Data System (ADS)
Davidson, Paul R.; Wolpert, Daniel M.
2005-09-01
Recent behavioural and computational studies suggest that access to internal predictive models of arm and object dynamics is widespread in the sensorimotor system. Several systems, including those responsible for oculomotor and skeletomotor control, perceptual processing, postural control and mental imagery, are able to access predictions of the motion of the arm. A capacity to make and use predictions of object dynamics is similarly widespread. Here, we review recent studies looking at the predictive capacity of the central nervous system which reveal pervasive access to forward models of the environment.
ERIC Educational Resources Information Center
Walsh, Anne
2010-01-01
The primary purpose of this study is to examine the connection between parent involvement and autonomy support, as well as the combined construct of autonomy supportive parent involvement, with internalized mental health symptoms. A secondary purpose of this study is to determine how certain parent demographics relate to attitudes and behaviors…
Validity and Reliability of Internalized Stigma of Mental Illness (Cantonese)
ERIC Educational Resources Information Center
Young, Daniel Kim-Wan; Ng, Petrus Y. N.; Pan, Jia-Yan; Cheng, Daphne
2017-01-01
Purpose: This study aims to translate and test the reliability and validity of the Internalized Stigma of Mental Illness-Cantonese (ISMI-C). Methods: The original English version of ISMI is translated into the ISMI-C by going through forward and backward translation procedure. A cross-sectional research design is adopted that involved 295…
Wu, Xiu Yun; Kirk, Sara F L; Ohinmaa, Arto; Veugelers, Paul J
2017-12-12
Poor mental health constitutes a considerable global public health burden with approximately half of all cases of poor mental health having their onset before the age of 14 years. The identification of modifiable risk factors early in life is therefore essential to prevention, however, there are presently very few longitudinal studies on health behaviours for mental health to inform public health decision makers and to justify preventive action. We examined the importance of diet quality, physical activity (PA) and sedentary behaviours in childhood for internalizing disorder throughout adolescence. We linked data from a population-based lifestyle survey among 10 and 11 year old grade five students in the Canadian province of Nova Scotia with physician diagnoses of internalizing disorders from administrative health records. We applied negative binomial regressions to examine the associations of health behaviours with the number of health care provider contacts with a diagnosis of internalizing disorder. Of the 4875 students, 23.9% had one or more diagnoses for internalizing disorder between the age of 10 or 11 years and 18 years. The number of health care provider contacts with a diagnosis of internalizing disorder was statistically significant higher among students with less variety in their diets, and among students who reported less PA and more time using computers and video games. The number of health care provider contacts was also higher for girls, and for students with low self-esteem and from low-income households. These findings suggest that diets and active lifestyles in childhood affect mental health during adolescence, and imply that succxessful health promotion programs targeting children's diets and activity will contribute to the prevention of mental health disorders in addition to the prevention of chronic diseases later in life.
Khizhnyak, V S; Otstavnova, E A
2015-01-01
Protection of human rights is a matter of priority for the international and Russian legislation. The State is responsible for respect of corresponding principles. Main documents on human rights were accepted by the United Nations and then by the European Council and WHO. They were generalized to psychiatric patients as well. In the Russian Federation, the main law concerning the rights of people with mental disorders is the law «On Psychiatric Care and Guarantees of Citizens. Rights during Its Provision» (1992). The authors pointed out that some fields of its implementation are not adequately explored in comparison to international situation on the protection of rights of patients with mental disorders.
Puckett, Jae A; Newcomb, Michael E; Garofalo, Robert; Mustanski, Brian
2016-09-01
Sexual minorities experience greater mental health issues compared to heterosexuals due to minority stressors. This study focused on the impact of victimization and neuroticism on mental health in young men who have sex with men (YMSM), and the mediating role of internalized homophobia (IH). IH refers to when a sexual minority person internalizes social bias and develops a negative view of themselves, which is a likely process through which victimization and neuroticism impact mental health. Data were collected over three time points across 12 months, with 450 YMSM (mean age = 18.9) and an 80.7% retention rate. Two mediation analyses with bias-corrected bootstrapping using 1000 samples were conducted, controlling for age, race, and sexual orientation. Results revealed that victimization [ F (9, 440) = 4.83, p < .001, R 2 = .09] and neuroticism [ F (9, 440) = 12.23, p < .001, R 2 = .20] had a significant indirect effect on mental health via increased levels of IH. These findings show how external experiences of stigma and personality level characteristics may impact YMSM in terms of their sense of self. Furthermore, these results support addressing social conditions that marginalize YMSM in order to promote better mental health through decreasing IH.
Puckett, Jae A.; Newcomb, Michael E.; Garofalo, Robert; Mustanski, Brian
2016-01-01
Sexual minorities experience greater mental health issues compared to heterosexuals due to minority stressors. This study focused on the impact of victimization and neuroticism on mental health in young men who have sex with men (YMSM), and the mediating role of internalized homophobia (IH). IH refers to when a sexual minority person internalizes social bias and develops a negative view of themselves, which is a likely process through which victimization and neuroticism impact mental health. Data were collected over three time points across 12 months, with 450 YMSM (mean age = 18.9) and an 80.7% retention rate. Two mediation analyses with bias-corrected bootstrapping using 1000 samples were conducted, controlling for age, race, and sexual orientation. Results revealed that victimization [F (9, 440) = 4.83, p < .001, R2 = .09] and neuroticism [F (9, 440) = 12.23, p < .001, R2 = .20] had a significant indirect effect on mental health via increased levels of IH. These findings show how external experiences of stigma and personality level characteristics may impact YMSM in terms of their sense of self. Furthermore, these results support addressing social conditions that marginalize YMSM in order to promote better mental health through decreasing IH. PMID:28138349
ERIC Educational Resources Information Center
Elkington, Katherine S.; Hackler, Dusty; Walsh, Tracy A.; Latack, Jessica A.; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.
2013-01-01
The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted…
Psychotherapy in an International Setting: A Malaysian Perspective.
ERIC Educational Resources Information Center
Kumaraswamy, N.
In spite of the development of medical services in Asian countries, mental illness and mental health services remain a stigma. An awareness of the causes and consequences of mental illness is also lacking. Since the 1990s, much work has been done in Malaysia to advance the people's concepts about the scientific approach to mental illness and to…
Oosterwijk, Suzanne; Mackey, Scott; Wilson-Mendenhall, Christine; Winkielman, Piotr; Paulus, Martin P.
2015-01-01
According to embodied cognition theories concepts are contextually-situated and grounded in neural systems that produce experiential states. This view predicts that processing mental state concepts recruits neural regions associated with different aspects of experience depending on the context in which people understand a concept. This neuroimaging study tested this prediction using a set of sentences that described emotional (e.g., fear, joy) and non-emotional (e.g., thinking, hunger) mental states with internal focus (i.e. focusing on bodily sensations and introspection) or external focus (i.e. focusing on expression and action). Consistent with our predictions, data suggested that the inferior frontal gyrus, a region associated with action representation, was engaged more by external than internal sentences. By contrast, the ventromedial prefrontal cortex, a region associated with the generation of internal states, was engaged more by internal emotion sentences than external sentence categories. Similar patterns emerged when we examined the relationship between neural activity and independent ratings of sentence focus. Furthermore, ratings of emotion were associated with activation in the medial prefrontal cortex, whereas ratings of activity were associated with activation in the inferior frontal gyrus. These results suggest that mental state concepts are represented in a dynamic way, using context-relevant interoceptive and sensorimotor resources. PMID:25748274
Campo-Arias, Adalberto; Herazo, Edwin
2014-01-01
The prolonged sociopolitical phenomenon of Colombian violence generated a high number of victims, many of whom suffered a continual process of internal displacement and stigma-discrimination complex. To postulate possible mechanisms by which victims of Colombia's internal armed conflict in a situation of forced displacement were stigmatized and discriminated. Stigma affects mental health, not only because it represents a major stressor for discriminated individuals and groups, but also because it accounts for inequalities and inequities in health. Initially, as the victims of the internal armed conflict in situation of forced displacement were not considered as such, but as responsible for the situation. Thus, they had to cope with the social and economic inequalities, explained partially by low categorization or status that they received, possibly due to poor construction of social capital in the country. Also, victims of the internal armed conflict suffer from intersectional stigma and discrimination due to other characteristics such as gender, sexual orientation, ethnic-racial origin, or meeting criteria for a mental disorder. An active process of inclusive social development is required for the displaced victims of the armed conflict,in order to reduce multiple stigma and ensure their mental health. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Mental contamination: The effects of religiosity.
Bilekli, Ilgun; Inozu, Mujgan
2018-03-01
Mental contamination, which occurs in the absence of contact with a contaminant, has a moral element. Previous studies evoked feelings of mental contamination via listening to a scenario, which described a non-consensual kiss. Since mental contamination has a moral element, we tested the effects of the level of religiosity on feelings of mental contamination and related variables in an experimental design. Female undergraduates of high religiosity (n = 48) and low religiosity (n = 44) were randomly assigned to listen to one of two audio recordings involving a consensual or non-consensual kiss from a man described as moral. Mental contamination feelings were evoked successfully in both groups. Effects of scenario condition and religiosity level were seen in mental contamination and related negative feelings. Participants who imagined a non-consensual kiss reported greatest feelings of mental contamination, and internal and external negative feelings. More importantly, high religiosity resulted in greater feelings of mental contamination, internal negative feelings, as well as urges to wash and actual washing behaviors. The current study was conducted on non-clinical Muslim females. This limits the generalization of the findings to the wider population. Mental contamination and related feelings can be seen in different forms at different levels of religiosity. Copyright © 2017 Elsevier Ltd. All rights reserved.
Killion, Chery M
2007-01-01
A nurse anthropologist with a background in international collaborations attended Project LEAD for two years, which enabled her to continue to serve as an advocate for the mentally ill in Belize. The anthropologist collaborated with a psychiatrist from Belize to develop a cross-cultural, cross-discipline publication, "Mental Health in Belize: A National Priority, " which highlights the work of psychiatric nurse practitioners in the country. The researcher learned to collaborate with her peer in Belize through face to face discussions and e-mail and overcame technological difficulties and cultural barriers to produce an international publication. Project LEAD gave the author a sense of self-discovery and self-knowledge, reinforced core values, and developed a frame of reference for leadership. The author also benefited from discussions by local, national, and international leaders on leadership in terms of its key components, contexts, challenges, triumphs, and styles.
Cramer, Robert J; La Guardia, Amanda C; Bryson, Claire; Morgan, Kelley
2017-01-01
To analyze the overlap of nonsuicidal self-injury (NSSI) and suicide-related behaviors (SRB) among college students with regard to demographics, mental health, and coping styles. Respondents were 572 undergraduate students at a southwestern public university. Data were collected in 2015. Respondents completed a demographic survey and assessments of NSSI, SRB, internalizing symptoms (ie, anxiety, stress, and depression), aggression, and negative coping strategies. The survey was administered via a Web-based procedure. Women reported more frequent cutting behaviors than men. Endorsement of NSSI was also associated with an increased likelihood of lifetime SRB. A subgroup of students endorsing both NSSI and SRB demonstrated poorer mental health, more negative coping, and self-reported female sex. College healthcare providers may benefit from competency-based training in techniques for the combination treatment of NSSI and SRB, as well as culturally based models of suicide.
Sansom-Daly, Ursula M; Wakefield, Claire E; McGill, Brittany C; Wilson, Helen L; Patterson, Pandora
2016-05-18
Online technologies may reduce barriers to evidence-based mental health care, yet they also create numerous ethical challenges. Recently, numerous professional organizations and expert groups have produced best-practice guidelines to assist mental health professionals in delivering online interventions in an ethically and clinically sound manner. However, there has been little critical examination of these international best-practice guidelines regarding appropriate electronic mental health (e-mental health) service delivery via technologies such as videoconferencing (including Skype), particularly for specific, vulnerable populations. Further, the extent to which concordance exists between these guidelines remains unclear. Synthesizing this literature to provide clear guidance to both mental health professionals and researchers is critical to ensure continued progress in the field of e-mental health. This study aims to review all currently available ethical and best-practice guidelines relating to videoconferencing-delivered mental health treatments in order to ascertain the recommendations for which international consensus could be found. Additionally, this review examines the extent to which each set of guidance addresses several key special populations, including children and young people, and populations living with illness. This systematic review examined guidelines using a two-armed search strategy, examining (1) professional organizations' published guidance; and (2) MEDLINE, PsycINFO, and EMBASE for the past ten years. In order to determine consensus for best-practice, a recommendation was considered "firm" if 50% or more of the reviewed guidelines endorsed it and "tentative" if recommended by fewer guidelines than these. The professional guidelines were also scored by two raters using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) criteria. In the study, 19 guidelines were included, yielding 11 specific "firm" and a further 123 "tentative-level" recommendations regarding the appropriateness of e-mental health, competence, legal and regulatory issues, confidentiality, consent, professional boundaries, and crisis management. International consensus yielded firm guidance across almost all areas except professional boundaries and some aspects of determining the appropriateness of e-mental health. Few guidelines specifically addressed special populations. Overall guideline quality varied; however, 42% (8/19) of the guidelines scored at least 5 out of 7. This synthesis of guidelines provides a foundation for clinicians and researchers utilizing e-mental health worldwide. The lack of specific guidance relating to special populations is an area warranting further attention in order to strengthen mental health professionals' and researchers' capacity to ethically and effectively tailor e-mental health interventions to these groups.
Stigma and demographic correlates of help-seeking intentions in returning service members.
Blais, Rebecca K; Renshaw, Keith D
2013-02-01
Many U.S. Iraq/Afghanistan-era veterans return from deployment with posttraumatic stress (PTS) symptoms, but few veterans seek psychological help. Research on barriers to care is growing, but the link between stigma and help-seeking is understudied. The present study examined anticipated enacted stigma from military and nonmilitary sources, self-stigma, PTS, perceived likelihood of deploying again, marital status, and history of mental health care engagement as correlates of help-seeking intentions from a mental health professional or medical doctor/advance practice registered nurse (MD/APRN) in a sample of 165 combat veterans. Using structural equation modeling, results demonstrated that self-stigma was negatively associated with help-seeking intentions from a mental health professional and MD/APRN with small-to-medium effect sizes. Being married was positively associated with help-seeking intentions from a mental health professional and MD/APRN with small effect sizes. History of previous mental health care engagement was positively associated with help-seeking intentions from a mental health professional with a medium effect size, but unrelated to help-seeking intentions from a MD/APRN. Anticipated enacted stigma from any source, PTS, and greater perceived likelihood of deploying again were unrelated to help-seeking intentions from a mental health professional and MD/APRN. Implications for interventions aimed at decreasing self-stigma and increasing intention to seek help are discussed. Copyright © 2013 International Society for Traumatic Stress Studies.
Cole, Donald C.; Muskat, Elisha; Raja, Shoba; Wiljer, David; Aylward, David
2016-01-01
In the debate in global mental health about the most effective models for developing and scaling interventions, there have been calls for the development of a more robust literature regarding the "non-specific", science of delivery aspects of interventions that are locally, contextually, and culturally relevant. This study describes a rigorous, exploratory, qualitative examination of the key, non-specific intervention strategies of a diverse group of five internationally-recognized organizations addressing mental illness in middle income countries (MICs). A triangulated approach to inquiry was used with semi-structured interviews conducted with service recipients, service providers and leaders, and key community partners (N = 159). The interview focus was upon processes of implementation and operation. A grounded theory-informed analysis revealed cross cutting themes of: a holistic conceptualization of mental health problems, an intensive application of principles of leverage and creating the social, cultural, and policy “space” within which interventions could be applied and resourced. These findings aligned with key aspects of systems dynamic theory suggesting that it might be a helpful framework in future studies of mental health service implementation in MICs. PMID:27011053
Moran, Galia Sharon; Russinova, Zlatka; Yim, Jung Yeon; Sprague, Catherine
2014-03-01
Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers-a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental health peer providers.
From local to global – Contributions of Indian psychiatry to international psychiatry
Murthy, R. Srinivasa
2010-01-01
Indian psychiatrists have actively engaged with world psychiatry by contributing to understanding and care of persons with mental disorders based on the religious, cultural and social aspects of Indian life. The contributions are significant in the areas of outlining the scope of mental health, classification of mental disorders, understanding the course of mental disorders, psychotherapy, traditional methods of care, role of family in mental health care and care of the mentally ill in the community settings. PMID:21836699
Dewa, Lindsay H; Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie
2018-03-03
Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Agreement in research priorities on a five-point scale. Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Protocol: A grounded theory of ‘recovery’—perspectives of adolescent users of mental health services
Palmquist, Lucianne; Patterson, Sue; O'Donovan, Analise; Bradley, Graham
2017-01-01
Introduction Policies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental illness, applicability to youth services and relevance to young people is uncertain, particularly as little is known about young people’s views. A comprehensive understanding of the experiences and expectations of young people is critical to developing youth mental health services that are acceptable, accessible, effective and relevant. Aim To inform development of policy and youth services, the study described in this protocol aims to develop a comprehensive account of the experiences and expectations of 12–17 year olds as they encounter mental disorders and transition through specialist mental health services. Data will be analysed to model recovery from the adolescents’ perspective. Method and analysis This grounded theory study will use quantitative and qualitative data collected in interviews with 12–17 year olds engaged with specialist Child/Youth Mental Health Service in Queensland, Australia. Interviews will explore adolescents’ expectations and experiences of mental disorder, and of services, as they transition through specialist mental health services, including the meaning of their experiences and ideas of ‘recovery’ and how their experiences and expectations are shaped. Data collection and analysis will use grounded theory methods. Ethics and dissemination Adolescents’ experiences will be presented as a mid-range theory. The research will provide tangible recommendations for youth-focused mental health policy and practice. Findings will be disseminated within academic literature and beyond to participants, health professionals, mental health advocacy groups and policy and decision makers via publications, research summaries, conferences and workshops targeting different audiences. Ethical and research governance approvals have been obtained from relevant Human Research Ethics committees and all sites involved. PMID:28729312
A comparative cross-sectional questionnaire survey of the work of UK and US mental health nurses.
Nolan, Peter; Haque, Sayeed; Doran, Maureen
2007-03-01
Comparative inter-country research which identifies similarities and differences in the work of mental health nurses in different social and political contexts is an important means of determining how changes in health care systems could lead to better outcomes for patients. This study sought to compare aspects of the work of nurses in US and UK mental health care settings. Nurses were invited to reflect on aspects of their role including identifying the most and least satisfying elements of their work and suggesting ways in which it could be improved. A 12-item questionnaire, comprising closed and open-ended questions, based on the literature and the authors' own experiences of mental health nursing practice, was piloted and subsequently distributed to respondents in both countries. The US nurses tended to be more willing to accept a wider range of clients than their UK counterparts, although they had lower expectations of their clients' likelihood of recovery. Both groups of nurses felt that being part of a team and having direct contact with clients were the most satisfying aspects of their work, while administration was the least. Although both US and UK nurses utilised a variety of intervention models, it would appear that Cognitive Behavioural Therapy was the favoured model for the majority of nurses. The implications of these findings for the work of nurses and mental health care services in the UK and US, and the purpose, nature and need for future international comparative research are discussed.
Comín Comín, Magdalena; Ruiz Garrós, Cristina; Franco, Esther; Damian, Javier; Ruiz Tovar, Maria; de Pedro-Cuesta, Jesús
2011-12-01
To quantify the use of the International Classification of Functioning, Disability and Health (ICF) in Spain on the basis of published reports, and to compare this use with that in other European countries. We reviewed the scientific literature published by, or with the participation of, authors having Spanish institutional affiliations in Spanish or international journals between May 2001 and June 2010. A total of 47 papers were identified, with a recent annual increase in those published in English. There was a predominance of theoretical journals (53.1%) and those specializing in mental health, rehabilitation and disability, with a medium or low impact factor. The World Health Organization-Disability Assessment Schedule (WHODAS-II) was used in 27.6% of publications. Most studies addressed adult populations with mental illness. Spain ranked midway in the table of European countries (fifth by Medline references). This review suggests that the effective application of the ICF in Spain is limited but is increasing and is internationally co-ordinated. The main fields of application are theoretical and diagnostic, in various clinical, rehabilitation and population-based contexts and, to a much lesser extent, in health services. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.
Oppositional defiant disorder dimensions: genetic influences and risk for later psychopathology.
Mikolajewski, Amy J; Taylor, Jeanette; Iacono, William G
2017-06-01
This study was undertaken to determine how well two oppositional defiant disorder (ODD) dimensions (irritable and headstrong/hurtful) assessed in childhood predict late adolescent psychopathology and the degree to which these outcomes can be attributed to genetic influences shared with ODD dimensions. Psychopathology was assessed via diagnostic interviews of 1,225 twin pairs at ages 11 and 17. Consistent with hypotheses, the irritable dimension uniquely predicted overall internalizing problems, whereas the headstrong/hurtful dimension uniquely predicted substance use disorder symptoms. Both dimensions were predictive of antisocial behavior and overall externalizing problems. The expected relationships between the irritable dimension and specific internalizing disorders were not found. Twin modeling showed that the irritable and headstrong/hurtful dimensions were related to late adolescent psychopathology symptoms through common genetic influences. Symptoms of ODD in childhood pose a significant risk for various mental health outcomes in late adolescence. Further, common genetic influences underlie the covariance between irritable symptoms in childhood and overall internalizing problems in late adolescence, whereas headstrong/hurtful symptoms share genetic influences with substance use disorder symptoms. Antisocial behavior and overall externalizing share common genetic influences with both the irritable and headstrong/hurtful dimensions. © 2017 Association for Child and Adolescent Mental Health.
Child Allergic Symptoms and Mental Well-Being: The Role of Maternal Anxiety and Depression☆
Teyhan, Alison; Galobardes, Bruna; Henderson, John
2014-01-01
Objective To determine whether maternal mental health mediates the relationship between eczema or asthma symptoms and mental well-being in children. Study design Analysis of 7250 children from the Avon Longitudinal Study of Parents and Children. Child mental well-being at 8 years was measured by the Strengths and Difficulties Questionnaire. Binary outcomes were high ‘internalizing’ (anxious/depressive) and ‘externalizing’ (oppositional/hyperactive) problems (high was >90th percentile). Child rash and wheeze categories were ‘none’; ‘early onset transient’ (infancy/preschool only); ‘persistent’ (infancy/preschool and at school age); and ‘late onset’ (school age only). Maternal anxiety and depression were reported during pregnancy and when child was 8 years old. Results Persistent wheezing symptoms were associated with high externalizing (OR 1.74, 95% CI, 1.41-2.15) and internalizing (1.67, 1.35-2.06) problems compared with never wheeze. Maternal anxiety and depression, and disrupted child sleep, attenuated these associations. Persistent rash (externalizing: 1.74, 1.40-2.15; internalizing: 1.42, 1.16-1.74) and late onset rash (externalizing: 1.62, 1.17-2.25; internalizing: 1.46, 1.07-1.99) symptoms were associated with poorer mental well-being compared with no rash at any age. Maternal anxiety and depression, particularly when child was aged 8 years rather than during pregnancy, accounted for the association with internalizing symptoms and partly for externalizing symptoms. Sleep disruption did not mediate the association. Conclusions Maternal anxiety and depression may mediate the association between child rash and wheeze and child mental well-being. PMID:24952709
Gatt, Justine M; Burton, Karen L O; Schofield, Peter R; Bryant, Richard A; Williams, Leanne M
2014-09-30
Mental health is not simply the absence of mental illness; rather it is a distinct entity representing wellness. Models of wellbeing have been proposed that emphasize components of subjective wellbeing, psychological wellbeing, or a combination of both. A new 26-item scale of wellbeing (COMPAS-W) was developed in a cohort of 1669 healthy adult twins (18-61 years). The scale was derived using factor analysis of multiple scales of complementary constructs and confirmed using tests of reliability and convergent validity. Bivariate genetic modeling confirmed its heritability. From an original 89 items we identified six independent subcomponents that contributed to wellbeing. The COMPAS-W scale and its subcomponents showed construct validity against psychological and physical health behaviors, high internal consistency (average r=0.71, Wellbeing r=0.84), and 12-month test-retest reliability (average r=0.62, Wellbeing r=0.82). There was a moderate contribution of genetics to total Wellbeing (heritability h(2)=48%) and its subcomponents: Composure (h(2)=24%), Own-worth (h(2)=42%), Mastery (h(2)=40%), Positivity (h(2)=42%), Achievement (h(2)=32%) and Satisfaction (h(2)=43%). Multivariate genetic modeling indicated genetic variance was correlated across the scales, suggesting common genetic factors contributed to Wellbeing and its subcomponents. The COMPAS-W scale provides a validated indicator of wellbeing and offers a new tool to quantify mental health. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Bøe, Tormod; Sivertsen, Børge; Heiervang, Einar; Goodman, Robert; Lundervold, Astri J; Hysing, Mari
2014-01-01
This study examined the role of parental emotional well-being and parenting practices as mediators of the association between familial socioeconomic status (SES) and child mental health problems. The sample included 2,043 5th-7th graders (50.7 % female) participating in the second wave of the Bergen Child Study. Children completed the Strengths and Difficulties Questionnaire, parents reported family economy and education level, emotional well-being (measured with the Everyday Feelings Questionnaire), and the use of negative disciplinary and affirmative parenting practices (measured using the Family Life Questionnaire). Path analyses were conducted to examine the associations between SES and externalizing and internalizing problems. Results supported a model where family economy was associated with externalizing problems through parental emotional well-being and parenting practices, whereas maternal education level was associated with externalizing problems through negative discipline. The direct association between paternal education level and externalizing problems was not mediated by parenting. For internalizing problems, we found both direct associations with family economy and indirect associations with family economy through parental emotional well-being and parenting. The results suggest that parental emotional well-being and parenting practices are two potential mechanisms through which low socioeconomic status is associated with child mental health problems.
Kerbage, Hala; El Chammay, Rabih; Richa, Sami
2016-01-01
Mental health legislation represents an important mean of protecting the rights of persons with mental disabilities by preventing human rights violations and discrimination and by legally reinforcing the objectives of a mental health policy. The last decade has seen significant changes in the laws relating to psychiatric practice all over the world, especially with the implementation of the Convention for the Rights of People with Disabilities (CRPD). In this paper, we review the existing legislation in Lebanon concerning the following areas in mental health: treatment and legal protection of persons with mental disabilities, criminal laws in relation to offenders with mental disorders, and laws regulating incapacity. We will discuss these texts in comparison with international recommendations and standards on the rights of persons with disabilities, showing the recurrent contradiction between them. Throughout our article, we will address the clinical dilemmas that Lebanese psychiatrists encounter in practice, in the absence of a clear legislation that can orient their decisions and protect their patients from abuse. Copyright © 2015. Published by Elsevier Ltd.
Wu, Heng; Zhao, Xudong; Fritzsche, Kurt; Salm, Florian; Leonhart, Rainer; Jing, Wei; Yang, Jianzhong; Schaefert, Rainer
2014-01-01
In western countries, negative illness perceptions are associated with poor health status and affect health outcomes in primary care populations. The aim of this study is to examine the relationship between illness perception and mental and physical health status in general hospital outpatients in China. This multicentre, cross-sectional study analysed a total of 281 consecutive patients from four general hospital outpatient departments of internal medicine and traditional Chinese medicine in Beijing and Kunming. The patients answered questionnaires concerning illness perception (Brief-IPQ), somatic symptom severity (Patient Health Questionnaire-15), illness behaviour (Scale for the Assessment of Illness Behaviour), emotional distress (Hospital Anxiety and Depression Scale) and health-related quality of life (Twelve-Item Short Form Health Survey). Negative illness perception, especially negative emotional reactions, perceived illness consequences, encumbering illness concerns, and strong illness identity were significantly associated with high emotional distress, impairing illness consequences, and a low mental and physical quality of life. Using a multiple linear regression model, five strongest correlates of negative illness perception were high anxiety, seeking diagnosis verification, low mental and physical quality of life and high somatic symptom severity. The variance explained by this model was 35%. Chinese general hospital outpatients showed associations between negative illness perceptions and poor mental and physical health status that were similar to those of primary care patients in western countries. The main difference was that no association with perceived illness control was found in Chinese patients. Chinese physicians should be sensitised to their patients' negative illness perceptions and should focus on helping patients cope with uncertainty and anxiety by providing an understandable illness model and increasing control beliefs.
The heterogeneity of mental representation: Ending the imagery debate.
Pearson, Joel; Kosslyn, Stephen M
2015-08-18
The possible ways that information can be represented mentally have been discussed often over the past thousand years. However, this issue could not be addressed rigorously until late in the 20th century. Initial empirical findings spurred a debate about the heterogeneity of mental representation: Is all information stored in propositional, language-like, symbolic internal representations, or can humans use at least two different types of representations (and possibly many more)? Here, in historical context, we describe recent evidence that humans do not always rely on propositional internal representations but, instead, can also rely on at least one other format: depictive representation. We propose that the debate should now move on to characterizing all of the different forms of human mental representation.
Mental Health and World Citizenship: The View from an International Nongovernmental Organization.
ERIC Educational Resources Information Center
Brody, Eugene B.
The lecture discussed the following topics: (1) the beginnings in 1948 of the World Federation for Mental Health, a global nongovernmental organization which conceived of mental health in social terms, linking mental health of individuals with that of communities and nations; (2) the limited goal in the late 20th century of citizenship in a world…
Using the K6 to Assess the Mental Health of Jailed Women
ERIC Educational Resources Information Center
Kubiak, Sheryl Pimlott; Beeble, Marisa L.; Bybee, Deborah
2009-01-01
Despite high prevalence rates, many jails lack validated measures or consistent processes for detecting mental illness. In this study, we examined the utility of the K6, an internationally used brief mental health screening measure within an urban jail. The K6 and several other mental health measures were administered to 515 jailed women. The K6…
Political violence and mental health: a multi-disciplinary review of the literature on Nepal.
Tol, Wietse A; Kohrt, Brandon A; Jordans, Mark J D; Thapa, Suraj B; Pettigrew, Judith; Upadhaya, Nawaraj; de Jong, Joop T V M
2010-01-01
Implementation of current international consensus guidelines regarding mental health and psychosocial support in emergencies requires the consideration of findings from both the medical and social sciences. This paper presents a multi-disciplinary review of reported findings regarding the relations between political violence, mental health and psychosocial wellbeing in Nepal. A systematic search of six databases resulted in the identification of 572 studies, of which 44 were included in the review. These studies investigated the influence of political violence on contextual variables that shape mental health and psychosocial wellbeing, and examined psychological distress and mental disorders in the context of political violence. The majority of studies addressed the mental health of Bhutanese refugees in Nepal and the impact of the Maoist People's War. Based upon these results from Nepal, we discuss a number of issues of concern to international researchers and practitioners and present policy and research recommendations. Specifically, we consider (a) the need for longitudinal multi-disciplinary research into protective and risk factors, including agency, of psychological distress and mental disorders in situations of political violence, (b) the continuing controversy regarding the PTSD construct, and (c) the lack of robust findings regarding the effectiveness of mental health and psychosocial support.
Citation analysis of mental health nursing journals: how should we rank thee?
Hunt, Glenn E; Happell, Brenda; Chan, Sally W-C; Cleary, Michelle
2012-12-01
The journal impact factor (JIF), and how best to rate the performance of a journal and the articles they contain, are areas of great debate. The aim of this paper was to assess various ranking methods of journal quality for mental health nursing journals, and to list the top 10 articles that have received the most number of citations to date. Seven mental health nursing journals were chosen for the analysis of citations they received in 2010, as well as their current impact factors from two sources, and other data for ranking purposes. There was very little difference in the top four mental health nursing journals and their overall rankings when combining various bibliometric indicators. That said, the International Journal of Mental Health Nursing is currently the highest ranked mental health nursing journal based on JIF, but publishes fewer articles per year compared to other journals. Overall, very few articles received 50 or more citations. This study shows that researchers need to consider more than one ranking method when deciding where to send or publish their research. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
ERIC Educational Resources Information Center
Schalock, Robert L.; Luckasson, Ruth
2004-01-01
This article provides an overview of the 2002 American Association on Mental Retardation's (AAMR's) "Definition, Classification, and Systems of Supports" (the 2002 System) and discusses its relationship to salient international trends and several scientific and judgmental issues currently impacting the field of intellectual disabilities (ID). Five…
Greene, M Claire; Jordans, Mark J D; Kohrt, Brandon A; Ventevogel, Peter; Kirmayer, Laurence J; Hassan, Ghayda; Chiumento, Anna; van Ommeren, Mark; Tol, Wietse A
2017-01-01
Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners with crucial background information to improve their capacity to work efficiently and with maximum benefit. In this paper, we draw on experience implementing desk review guidance from the World Health Organization (WHO) and UNHCR, the United Nations Refugee Agency (2012) in four diverse humanitarian crises (earthquakes in Haiti and Nepal; forced displacement among Syrians and Congolese). We discuss critical parameters for the design and implementation of desk reviews, and discuss current challenges and future directions to improve mental health care and psychosocial support in humanitarian emergencies.
Personality disorders and criminal law: an international perspective.
Sparr, Landy F
2009-01-01
At the International War Crimes Tribunal for the Former Yugoslavia (ICTY), a detention camp guard, charged with acts of murder and torture, advanced a plea of diminished responsibility. Defense psychiatrists testified that he had a personality disorder that influenced his ability to control his behavior, but a prosecution expert testified that the guard did not meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. Thus, the unresolved question of how the law defines a mental disease or defect for purposes of mitigation or excuse was transposed to an international setting. It has been argued in a variety of jurisdictions and national legal systems that exculpatory mental disorders must be serious, and personality disorders should not qualify. In fact, it has been proposed that the volitional aspect of excuse defenses be eliminated, and definitions of mental disease or defect narrowed. Others have argued that such exclusions are too restrictive and arbitrary. This article examines the criminal defense at ICTY and traces its origin in national jurisdictions. Mental incapacity defenses based on personality disorders are more often used in The Netherlands, England, Germany and Belgium, but seldom in Canada and rarely in the United States and Sweden.
Li, Jie; Chang, Shu-Sen; Yip, Paul S F; Li, Juan; Jordan, Lucy P; Tang, Yunge; Hao, Yuantao; Huang, Xingmei; Yang, Ning; Chen, Chaoqi; Zeng, Qiaomei
2014-12-16
There has been a dramatic increase in internal migrant workers in China over recent decades, and there is a recent concern of poor mental health particularly amongst younger or "new generation" migrants who were born in 1980 or later. A cross-sectional study was conducted in Guangzhou city between May and July in 2012. Mental wellbeing was measured using the World Health Organization Five-item Well-Being Index Scale and the 36 Item Short Form Health Survey mental health scale. Linear and logistic regression models were used to investigate the differences between migrant workers and their urban counterparts and between younger and older migrants. Migrant workers (n = 914) showed a small but significant advantage in mental wellbeing compared to their urban counterparts (n = 814). There was some evidence for age modification effect (p for interaction = 0.055-0.095); better mental wellbeing in migrants than urbanites were mainly seen in the older compared to the younger group, and the difference attenuated somewhat after controlling for income satisfaction. Older migrants showed better mental health than younger migrants. Factors that were independently associated with poor mental health in migrants included being male, longer working hours, and income dissatisfaction, whilst older age, factory job, high income, and increased use of social support resources were associated with reduced risk. Efforts to promote mental health amongst migrant workers may be usefully targeted on younger migrants and include measures aimed to improve working conditions, strengthen the social support network, and address age-specific needs.
ten Have, Margreet; Oldehinkel, Albertine; Vollebergh, Wilma; Ormel, Johan
2005-06-01
Little is known about the role of personality characteristics in service utilisation for mental health problems. We investigate whether neuroticism: 1) predicts the use of primary and specialised care services for mental health problems, independently of whether a person has an emotional disorder; and 2) modifies any association between emotional disorder and service use. Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) a prospective cohort study in the general population aged 18-64. Neuroticism was recorded at baseline, and emotional disorder and service use at 12-month follow-up, in a representative sample (N=7076), using the Composite International Diagnostic Interview. People with high neuroticism were more likely to receive care in the specialised mental health sector, and after entry to care they made more visits to the services, whether or not they had an emotional disorder. If they had an emotional disorder, their likelihood of receiving specialised mental health care showed an additional increase. Neuroticism also predicted the use of primary care for mental health problems, but greater numbers of visits were made only by clients with both high neuroticism and an emotional disorder. It would be useful to incorporate personality characteristics into models to understand variations in service utilisation for mental health problems. The findings suggest that professionals would be wise to focus not just on their clients' emotional problems and disorders, but also on strengthening their problem-solving abilities through approaches like cognitive behavioural therapy.
Dominant vs. nondominant arm advantage in mentally simulated actions in right handers.
Gandrey, Philippe; Paizis, Christos; Karathanasis, Vassilis; Gueugneau, Nicolas; Papaxanthis, Charalambos
2013-12-01
Although plentiful data are available regarding mental states involving the dominant-right arm, the evidence for the nondominant-left arm is sparse. Here, we investigated whether right-handers can generate accurate predictions with either the right or the left arm. Fifteen adults carried out actual and mental arm movements in two directions with varying inertial resistance (inertial anisotropy phenomenon). We recorded actual and mental movement times and used the degree of their similarity as an indicator for the accuracy of motor imagery/prediction process. We found timing correspondences (isochrony) between actual and mental right arm movements in both rightward (low inertia resistance) and leftward (high inertia resistance) directions. Timing similarities between actual and mental left arm movements existed for the leftward direction (low inertia resistance) but not for the rightward direction (high inertia resistance). We found similar results when participants reaching towards the midline of the workspace, a result that excludes a hemispace effect. Electromyographic analysis during mental movements showed that arm muscles remained inactivate, thus eliminating a muscle activation strategy that could explain intermanual differences. Furthermore, motor-evoked potentials enhancement in both right and left biceps brachii during mental actions indicated that subjects were actively engaged in mental movement simulation and that the disadvantage of the left arm cannot be attributed to the nonactivation of the right motor cortex. Our findings suggest that predictive mechanisms are more robust for the right than the left arm in right-handers. We discussed these findings from the perspective of the internal models theory and the dynamic-dominance hypothesis of laterality.
Using concept maps to describe undergraduate students’ mental model in microbiology course
NASA Astrophysics Data System (ADS)
Hamdiyati, Y.; Sudargo, F.; Redjeki, S.; Fitriani, A.
2018-05-01
The purpose of this research was to describe students’ mental model in a mental model based-microbiology course using concept map as assessment tool. Respondents were 5th semester of undergraduate students of Biology Education of Universitas Pendidikan Indonesia. The mental modelling instrument used was concept maps. Data were taken on Bacteria sub subject. A concept map rubric was subsequently developed with a maximum score of 4. Quantitative data was converted into a qualitative one to determine mental model level, namely: emergent = score 1, transitional = score 2, close to extended = score 3, and extended = score 4. The results showed that mental model level on bacteria sub subject before the implementation of mental model based-microbiology course was at the transitional level. After implementation of mental model based-microbiology course, mental model was at transitional level, close to extended, and extended. This indicated an increase in the level of students’ mental model after the implementation of mental model based-microbiology course using concept map as assessment tool.
The changing purpose of mental health law: From medicalism to legalism to new legalism.
Brown, Jennifer
2016-01-01
The role of law in regulating mental health detention has come to engender great contention in the legal and sociological disciplines alike. This conflict is multifaceted but is centred upon the extent to which law should control the psychiatric power of detention. In this manner the evolution of law regulating mental health detention has been seen in terms of a pendulous movement between two extremes of medicalism and legalism. Drawing on socio-legal literature, legislation, international treaties and case law this article examines the changing purpose of mental health law from an English and Council of Europe perspective by utilizing the concepts of medicalism, legalism and new legalism as descriptive devices before arguing that the UN Convention on the Rights of Persons with Disabilities goes further than all of these concepts and has the potential to influence mental health laws internationally. Copyright © 2016 Elsevier Ltd. All rights reserved.
Parental use of corporal punishment in Europe: intersection between public health and policy.
duRivage, Nathalie; Keyes, Katherine; Leray, Emmanuelle; Pez, Ondine; Bitfoi, Adina; Koç, Ceren; Goelitz, Dietmar; Kuijpers, Rowella; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Fermanian, Christophe; Kovess-Masfety, Viviane
2015-01-01
Studies have linked the use of corporal punishment of children to the development of mental health disorders. Despite the recommendation of international governing bodies for a complete ban of the practice, there is little European data available on the effects of corporal punishment on mental health and the influence of laws banning corporal punishment. Using data from the School Children Mental Health Europe survey, the objective of this cross-sectional study was to examine the prevalence and legal status of corporal punishment across six European countries and to evaluate the association between parental use of corporal punishment and children's mental health. The study found that odds of having parents who reported using occasional to frequent corporal punishment were 1.7 times higher in countries where its use is legal, controlling for socio-demographic factors. Children with parents who reported using corporal punishment had higher rates of both externalized and internalized mental health disorders.
Slimani, Maamer; Tod, David; Chaabene, Helmi; Miarka, Bianca; Chamari, Karim
2016-01-01
The aims of the present review were to (i) provide a critical overview of the current literature on the effects of mental imagery on muscular strength in healthy participants and patients with immobilization of the upper extremity (i.e., hand) and anterior cruciate ligament (ACL), (ii) identify potential moderators and mediators of the “mental imagery-strength performance” relationship and (iii) determine the relative contribution of electromyography (EMG) and brain activities, neural and physiological adaptations in the mental imagery-strength performance relationship. This paper also discusses the theoretical and practical implications of the contemporary literature and suggests possible directions for future research. Overall, the results reveal that the combination of mental imagery and physical practice is more efficient than, or at least comparable to, physical execution with respect to strength performance. Imagery prevention intervention was also effective in reducing of strength loss after short-term muscle immobilization and ACL. The present review also indicates advantageous effects of internal imagery (range from 2.6 to 136.3%) for strength performance compared with external imagery (range from 4.8 to 23.2%). Typically, mental imagery with muscular activity was higher in active than passive muscles, and imagining “lifting a heavy object” resulted in more EMG activity compared with imagining “lifting a lighter object”. Thus, in samples of students, novices, or youth male and female athletes, internal mental imagery has a greater effect on muscle strength than external mental imagery does. Imagery ability, motivation, and self-efficacy have been shown to be the variables mediating the effect of mental imagery on strength performance. Finally, the greater effects of internal imagery than those of external imagery could be explained in terms of neural adaptations, stronger brain activation, higher muscle excitation, greater somatic and sensorimotor activation and physiological responses such as blood pressure, heart rate, and respiration rate. Key points Coupling mental imagery with physical training is the best suited intervention for improving strength performance. An examination of potential moderator variables revealed that the effectiveness of mental imagery on strength performance may vary depending on the appropriate matching of muscular groups, the characteristics of mental imagery interventions, training duration, and type of skills. Self-efficacy, motivation, and imagery ability were the mediator variables in the mental imagery-strength performance relationship. Greater effects of internal imagery perspective on strength performance than those of external imagery could be explained in terms of neural adaptations, stronger brain activation, higher muscles excitation, greater somatic and sensorimotor activation, and higher physiological responses such as blood pressure, heart rate, and respiration rate. Mental imagery prevention interventions may provide a valuable tool to improve the functional recovery after short-term muscle immobilization and anterior cruciate ligament in patients. PMID:27803622
Brown-Johnson, Cati G.; Cataldo PhD, Janine K.; Orozco, Nicholas; Lisha, Nadra E.; Hickman, Norval; Prochaska, Judith J.
2015-01-01
Background and Objectives De-normalization of smoking as a public health strategy may create shame and isolation in vulnerable groups unable to quit. To examine the nature and impact of smoking stigma, we developed the Internalized Stigma of Smoking Inventory (ISSI), tested its validity and reliability, and explored factors that may contribute to smoking stigma. Methods We evaluated the ISSI in a sample of smokers with mental health diagnoses (N=956), using exploratory and confirmatory factor analysis, and assessed construct validity. Results Results reduced the ISSI to 8 items with three subscales: smoking self-stigma related to shame, felt stigma related to social isolation, and discrimination experiences. Discrimination was the most commonly endorsed of the three subscales. A multivariate generalized linear model predicted 21-30% of the variance in the smoking stigma subscales. Self-stigma was greatest among those intending to quit; felt stigma was highest among those experiencing stigma in other domains, namely ethnicity and mental illness-based; and smoking-related discrimination was highest among women, Caucasians, and those with more education. Discussion and Conclusion Smoking stigma may compound stigma experiences in other areas. Aspects of smoking stigma in the domains of shame, isolation, and discrimination related to modeled stigma responses, particularly readiness to quit and cigarette addiction and was found to be more salient for groups where tobacco use is least prevalent. Scientific Significance The ISSI measure is useful for quantifying smoking-related stigma in multiple domains. PMID:25930661
Measuring mental workload: ocular astigmatism aberration as a novel objective index.
Jiménez, Raimundo; Cárdenas, David; González-Anera, Rosario; Jiménez, José R; Vera, Jesús
2018-04-01
This study assessed the effect of two perceptually matched mental tasks with different levels of mental demand on ocular aberrations in a group of young adults. We measured ocular aberration with a wavefront sensor, and total, internal and corneal RMS (root mean square) aberrations were calculated from Zernike coefficients, considering natural and scaled pupils (5, 4.5, and 4 mm). We found that total, internal and corneal astigmatism RMS showed significant differences between mental tasks with natural pupils (p < .05), and this effect was maintained with 5 mm scaled pupils (total RMS astigmatism, p < .05). Consistently, pupil size, intraocular pressure, perceived mental load and cognitive performance were influenced by the level of mental complexity (p < .05 for all). The findings suggest that ocular astigmatism aberration, mediated by intraocular pressure, could be an objective, valid reliable index to evaluate the impact of cognitive processing in conjunction with others physiological markers in real world contexts. Practitioner Summary: The search continues for a valid, reliable, convenient method of measuring mental workload. In this study we found ocular astigmatism aberration is sensitive to the cumulative effect of mental effort. It shows promise of being a novel ocular index which may help to assess mental workload in real situations.
Social inclusion of the people with mental health issues: Compare international results.
Santos, Jussara Carvalho Dos; Barros, Sônia; Huxley, Peter John
2018-06-01
Social inclusion of people with mental health issues is an aim of the World Health Organisation. Many countries have adopted that objective, including Brazil and the United Kingdom and both have focused treatment in the community. The aim of this article is to compare international results using the same inclusion instrument. The samples in this study were 225 people with mental health issues in community services in São Paulo, Brazil. Their results are compared to findings from 168 people with similar mental health issues in Hong Kong, China, and from the United Kingdom - a nationally representative sample of 212 people without mental health issues. The instrument used to measure a social inclusion called Social and Communities Opportunities Profile (SCOPE) has been validated for use in the United Kingdom, China and Brazil. The results are that people with mental health issues have worse social inclusion when compared to general population. Between the people with mental health issues, the sample of São Paulo has the lowest social inclusion index but, in relation to access to the Brazilian revised mental health services, that sample has a similarly high inclusion rating to the general population of the United Kingdom. Findings are important to understand mental health in the community context, as well as their adversities and potentialities.
A Multidimensional Analysis of the Mental Health of Graduate Counselors in Training.
ERIC Educational Resources Information Center
White, Paul E.; Franzoni, Janet B.
1990-01-01
Examined level of mental health of 180 graduate counselor trainees. Gathered multidimensional mental health information using seven clinical scales of Minnesota Multiphasic Personality Inventory (MMPI), Adult Nowicki-Strickland Internal-External Control Scale, Life Style Personality Inventory, and Coping Resources Inventory for Stress. Trainees…
Taylor, Robert Joseph; Chatters, Linda M.; Abelson, Jamie M.
2012-01-01
This study explores relationships between lifetime and 12 month DSM-IV major depressive disorder and religious involvement within a nationally representative sample of African American adults (n=3,570). MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI). Multivariate findings indicate that reading religious materials was positively associated with 12 month (OR=1.14, 95% CI=1.001 - 1.29) and lifetime MDD (OR=1.12, 95% CI=1.03 - 1.21), religious service attendance was inversely associated with 12 month and lifetime MDD, and religious coping was inversely associated with 12 month MDD (OR=0.75, 95% CI=.57 - 0.99). Findings are discussed in relation to the role of religion for African American mental health, prior research on the effects of religious involvement on physical and mental health, and theoretical and conceptual models of religion-health connections that specify multiple and often divergent pathways (e.g., prevention, resource mobilization) by which diverse forms of religious involvement impact mental health. PMID:22986280
Clashing Diagnostic Approaches: DSM-ICD versus RDoC
Lilienfeld, Scott O.; Treadway, Michael T.
2016-01-01
Since at least the middle of the past century, one overarching model of psychiatric classification, namely, that of the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases (DSM-ICD), has reigned supreme. This DSM-ICD approach embraces an Aristotelian view of mental disorders as largely discrete entities that are characterized by distinctive signs, symptoms, and natural histories. Over the past several years, however, a competing vision, namely, the Research Domain Criteria (RDoC) initiative launched by the National Institute of Mental Health, has emerged in response to accumulating anomalies within the DSM-ICD system. In contrast to DSM-ICD, RDoC embraces a Galilean view of psychopathology as the product of dysfunctions in neural circuitry. RDoC appears to be a valuable endeavor that holds out the long-term promise of an alternative system of mental illness classification. We delineate three sets of pressing challenges – conceptual, methodological, and logistical/pragmatic – that must be addressed for RDoC to realize its scientific potential, and conclude with a call for further research, including investigation of a rapprochement between Aristotelian and Galilean approaches to psychiatric classification. PMID:26845519
Functionalism and consciousness.
Shoemaker, S
1993-01-01
It is widely held that a mental state and the subject's introspective belief about it are always 'distinct existences' and only contingently connected. This suggests that for each sort of mental state there could be a creature that is introspectively 'blind' with respect to states of that sort, meaning that while it is capable of having such states, and of conceiving of itself as having them, it is totally without introspective access to its states of that sort. It is argued here that introspective blindness with respect to many sorts of mental states, in particular beliefs and sensory states, is not a possibility, because it is incompatible with requirements of rationality that are internal to the functional roles that are constitutive of these states. Introspective accessibility is essential to the functional roles of such mental states when the conceptual and cognitive resources of the subject of those states are sufficiently rich to make beliefs and thoughts about them a possibility. This is a version of the view that such states are necessarily self-intimating and is incompatible with the perceptual model of introspection favoured by some functionalists as well as by many non-functionalists.
Olafsdottir, Sigrun
2017-03-01
The aims of this study were to: (a) compare gender differences in mental well-being in the Nordic countries with gender differences in 28 other countries around the world; and (b) evaluate whether gender differences in the Nordic countries remain when other social and lifestyle factors are taken into account. Data were obtained from 32 countries around the world that participated in the 2011 health module of the International Social Survey Programme. Ordered logit regression models were used to evaluate whether gender differences remained significant when other social and lifestyle factors were considered. Gender differences in mental well-being in the Nordic countries are not particularly small and the four countries do not cluster together. The gender differences remain when other social and lifestyle factors are taken into account. There appears to be a similar Nordic health paradox for mental well-being outcomes as for physical health outcomes. Although there may be multiple reasons for this, continued gender equality, including sex segregation in the labour market and gendered expectations, are considered to play a part.
Thinking as the control of imagination: a conceptual framework for goal-directed systems.
Pezzulo, Giovanni; Castelfranchi, Cristiano
2009-07-01
This paper offers a conceptual framework which (re)integrates goal-directed control, motivational processes, and executive functions, and suggests a developmental pathway from situated action to higher level cognition. We first illustrate a basic computational (control-theoretic) model of goal-directed action that makes use of internal modeling. We then show that by adding the problem of selection among multiple action alternatives motivation enters the scene, and that the basic mechanisms of executive functions such as inhibition, the monitoring of progresses, and working memory, are required for this system to work. Further, we elaborate on the idea that the off-line re-enactment of anticipatory mechanisms used for action control gives rise to (embodied) mental simulations, and propose that thinking consists essentially in controlling mental simulations rather than directly controlling behavior and perceptions. We conclude by sketching an evolutionary perspective of this process, proposing that anticipation leveraged cognition, and by highlighting specific predictions of our model.
Robot Lies in Health Care: When Is Deception Morally Permissible?
Matthias, Andreas
2015-06-01
Autonomous robots are increasingly interacting with users who have limited knowledge of robotics and are likely to have an erroneous mental model of the robot's workings, capabilities, and internal structure. The robot's real capabilities may diverge from this mental model to the extent that one might accuse the robot's manufacturer of deceiving the user, especially in cases where the user naturally tends to ascribe exaggerated capabilities to the machine (e.g. conversational systems in elder-care contexts, or toy robots in child care). This poses the question, whether misleading or even actively deceiving the user of an autonomous artifact about the capabilities of the machine is morally bad and why. By analyzing trust, autonomy, and the erosion of trust in communicative acts as consequences of deceptive robot behavior, we formulate four criteria that must be fulfilled in order for robot deception to be morally permissible, and in some cases even morally indicated.
De Las Cuevas, Carlos; de Leon, Jose; Peñate, Wenceslao; Betancort, Moisés
2017-01-01
To evaluate pathways through which sociodemographic, clinical, attitudinal, and perceived health control variables impact psychiatric patients' adherence to psychopharmacological medications. A sample of 966 consecutive psychiatric outpatients was studied. The variables were sociodemographic (age, gender, and education), clinical (diagnoses, drug treatment, and treatment duration), attitudinal (attitudes toward psychopharmacological medication and preferences regarding participation in decision-making), perception of control over health (health locus of control, self-efficacy, and psychological reactance), and level of adherence to psychopharmacological medications. Structural equation modeling was applied to examine the nonstraightforward relationships and the interactive effects among the analyzed variables. Structural equation modeling demonstrated that psychiatric patients' treatment adherence was associated: 1) negatively with cognitive psychological reactance (adherence decreased as cognitive psychological reactance increased), 2) positively with patients' trust in their psychiatrists (doctors' subscale), 3) negatively with patients' belief that they are in control of their mental health and that their mental health depends on their own actions (internal subscale), and 4) positively (although weakly) with age. Self-efficacy indirectly influenced treatment adherence through internal health locus of control. This study provides support for the hypothesis that perceived health control variables play a relevant role in psychiatric patients' adherence to psychopharmacological medications. The findings highlight the importance of considering prospective studies of patients' psychological reactance and health locus of control as they may be clinically relevant factors contributing to adherence to psychopharmacological medications.
The impact of mental health disorders on 30-day readmission after bariatric surgery.
Litz, Megan; Rigby, Andrea; Rogers, Ann M; Leslie, Douglas L; Hollenbeak, Christopher S
2018-03-01
Mental health disorders are common among bariatric surgery patients. Mental health disorders, particularly depression, have been associated with poorer surgical outcomes, indicating the bariatric surgery patient population warrants special clinical attention. Our study sought to examine the effect of diagnosed mental health disorders on 30-day readmission for those undergoing bariatric surgery in hospitals across Pennsylvania from 2011 to 2014. We used Pennsylvania Healthcare Cost Containment Council data to perform this analysis. Inclusion criteria encompassed patients aged>18 years who underwent bariatric surgery at any hospital or freestanding surgical facility in Pennsylvania between 2011 and 2014. Mental health disorders were identified using predetermined International Classification of Disease, Ninth Revision codes. Logistic regression was used to model the risk of 30-day readmission and estimate the effect of mental health disorders on 30-day readmission. Of the 19,259 patients who underwent bariatric surgery, 40.3% had a diagnosed mental health disorder; 6.51% of all patients were readmitted within 30 days. Patients with a diagnosed mental health disorder had 34% greater odds of readmission (odds ratio = 1.34, 95% confidence interval: 1.19-1.51) relative to patients with no diagnosed mental health disorder. Patients with major depressive disorder/bipolar disorder had 46% greater odds of being readmitted compared with patients with no major depressive disorder/bipolar disorder diagnosis. Study findings imply the need for risk assessment of patients before postoperative discharge. Given that patients with mental health diagnoses are at increased risk of 30-day readmission after bariatric surgery, they may benefit from additional discharge interventions designed to attenuate potential readmissions. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Toppelberg, Claudio O; Hollinshead, Marisa O; Collins, Brian A; Nieto-Castañon, Alfonso
2013-06-01
The aim of the study is to examine the rates of mental health service utilization in young Latino children of immigrants in relation to maternal and teacher reports of child mental health need. Specific knowledge is lacking about gaps in service utilization among young Latino children, the fastest growing and possibly the most underserved segment of the US child population. The associations of mental health service utilization (Service Assessment for Children and Adolescents) and mental health need (clinical levels of internalizing, externalizing, or total problems reported by mothers [Child Behavior Checklist] and teachers [Teacher's Report Form]) were examined in a community sample of young Latino children of immigrants ( n = 228; mean age = 6) and compared across mothers' and teachers' responses. Mother-teacher agreement was also studied. Sixty-five children (28.5 %) had a mental health need; most (76.9 %) of these received no services. For all types of mental health need, service utilization was more likely when need was reported by mothers rather than teachers ( p = .03). Teachers' reports were not associated with service utilization. Mother-teacher agreement was low for externalizing ( r = .23; p ≤ 0.01) and total problems ( r = .21; p ≤ 0.05), and nonsignificant for internalizing problems. This study is the first in the United States to document, in such a young Latino group, high rates of unmet need comparable to those among older Latino youth; low or no mother-teacher agreement on which children had a mental health need; low utilization of school-based services; and a lack of association between service utilization and teacher-reported mental health need-both for externalizing and internalizing problems. These findings suggest that schools are not effectively leveraging mental health services for young Latino children. Potential factors responsible for the findings are discussed.
Relationships among Stress, Coping, and Mental Health in High-Achieving High School Students
ERIC Educational Resources Information Center
Suldo, Shannon M.; Shaunessy, Elizabeth; Hardesty, Robin
2008-01-01
This study investigates the relationships among stress, coping, and mental health in 139 students participating in an International Baccalaureate (IB) high school diploma program. Mental health was assessed using both positive indicators (life satisfaction, academic achievement, academic self-efficacy) and negative indicators (psychopathology) of…
Competence and Adjustment of Siblings of Children with Mental Retardation.
ERIC Educational Resources Information Center
Hannah, Mary E.; Midlarsky, Elizabeth
1999-01-01
This study compared the adjustment and competence of 100 children and adolescents, half of whom were siblings of individuals with mental retardation. Although there were no overall differences for internalizing disorders, externalizing disorders, self-esteem, and competence, boys with a mentally retarded sibling had more difficulty in school…
Mewes, Ricarda; Rief, Winfried; Kenn, Klaus; Ried, Jens; Stenzel, Nikola
2016-01-01
Individuals with chronic obstructive pulmonary disease (COPD) exhibit low physical and mental health-related quality of life (HRQL) and high susceptibility to disability. We investigated the influence of psychological factors on HRQL and disability in COPD individuals recruited from the general population. In line with Leventhal's common sense model, we expected psychological factors to be associated with HRQL and disability even after controlling for medical status. Individuals with COPD (n = 502; 59.7 years old; GOLD grades were I: 3%, II: 17%, III: 34%, IV: 46%) were assessed through an online survey administered via COPD patient organisations in Germany. Individuals filled in the Short Form Health Survey (SF-12), COPD Assessment Test, Patient Health Questionnaire (modules: GAD-2, PHQ-15, PHQ-9), Brief Illness Perception Questionnaire, a questionnaire that assesses causal illness attributions, and the internal illness-related locus of control scale of the 'KKG questionnaire for the assessment of control beliefs about illness and health'. Multiple linear regressions were calculated. The investigated factors explained high variances (disability = 56%, physical HRQL = 28%, mental HRQL = 63%, p ≤ .001). Better mental health, more optimistic illness perceptions, attribution to psychological causes, and stronger internal locus of control were associated with lower disability and better HRQL. Comorbid somatic symptoms contributed to high disability and low quality of life. Psychological factors, such as illness perception, attribution and internal locus of control, were associated with disability and HRQL. These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills.
Deardorff, J.; Cham, H.; Gonzales, NA.; White, R.M.B.; Tein, J.-Y.; Wong, J.; Roosa, M.W.
2012-01-01
Early-maturing girls are at risk for internalizing and externalizing problems. Scarce research has examined pubertal timing and mental health among Mexican Americans, or examined the influence of parenting behaviors on these relations. This study addressed these gaps. This was a prospective examination of 362 Mexican-origin girls and their mothers using three waves of data. Measures included girls’ self-report of pubertal development and girls’ and mothers’ report of maternal harsh parenting and daughters’ mental health. Using structural equation modeling, we examined whether pubertal timing in 5th grade predicted girls’ internalizing and externalizing outcomes in 10th grade. We also examined the mediating and moderating effects of harsh parenting on the relations between pubertal timing and internalizing and externalizing behaviors, as well as the influence of mothers’ and daughters’ nativity on these relations. Results differed depending on reporter and maternal nativity. Using daughters’ report, Mexican American mothers’ harsh parenting acted as a moderator. At high levels of harsh parenting, early pubertal timing predicted higher externalizing scores, while at low levels of harsh parenting, early timing predicted lower externalizing scores. For Mexican immigrant mothers, harsh parenting mediated the effects of pubertal timing on girls’ internalizing and externalizing problems. There were no significant pubertal effects for mothers’ report. Findings suggest that maternal harsh parenting plays a key role in the relations between early pubertal timing and behavioral and emotional outcomes among Mexican-origin girls. PMID:23231686
Deardorff, Julianna; Cham, Heining; Gonzales, Nancy A; White, Rebecca M B; Tein, Jenn-Yun; Wong, Jessie J; Roosa, Mark W
2013-09-01
Early-maturing girls are at risk for internalizing and externalizing problems. Research concerning pubertal timing and mental health among Mexican Americans or the influence of parenting behaviors on these relations has been scarce. This study addressed these gaps. This was a prospective examination of 362 Mexican-origin girls and their mothers in 3 waves of data. Measures included girls' self-report of pubertal development and girls' and mothers' report of maternal harsh parenting and daughters' mental health. Using structural equation modeling, we examined whether pubertal timing in 5th grade predicted girls' internalizing and externalizing outcomes in 10th grade. We also examined the mediating and moderating effects of harsh parenting on the relations between pubertal timing and internalizing and externalizing behaviors, as well as the influence of mothers' and daughters' nativity on these relations. Results differed depending on reporter and maternal nativity. Using daughters' report, we found that Mexican American mothers' harsh parenting acted as a moderator. At high levels of harsh parenting, early pubertal timing predicted higher externalizing scores, while at low levels of harsh parenting, early timing predicted lower externalizing scores. For Mexican immigrant mothers, harsh parenting mediated the effects of pubertal timing on girls' internalizing and externalizing problems. There were no significant pubertal effects for mothers' report. Findings suggest that maternal harsh parenting plays a key role in the relations between early pubertal timing and behavioral and emotional outcomes among Mexican-origin girls. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Dewaele, Alexis; Van Houtte, Mieke; Vincke, John
2014-11-01
The role of visibility management strategies, as an extended measure of outness related to sexual orientation, has been rarely studied with the aim of explaining the experience of external stressors (i.e., experiences of everyday discrimination and perceived sanctioning of cross-gender behavior) and internal stressors (i.e., internalized homonegativity and general mental distress). In this study, we examined gender differences within these relationships. A non-representative sample of 2,378 lesbians, gay men, and bisexuals was recruited. We found that lesbian and bisexual women scored significantly higher on perceived cross-gender sanctioning and general mental distress compared to gay and bisexual men. Multivariate analysis showed that visibility management was significantly related to the experience of internalized homonegativity in both men and women. Visibility management mediated the relationship between experiences of every day discrimination on the one hand and internalized homonegativity and general mental distress on the other. Finally, we found that compared to gay and bisexual men, lesbian and bisexual women who maintained relatively closed visibility management strategies, reported lower scores on internalized homonegativity but higher scores on general mental distress. We found fewer gender differences related to visibility management than expected and those that we did find were relatively small. Flemish lesbian and bisexual women and gay and bisexual men appear to more alike than different.
Maas, Lillian; Ezeobele, I Ezebuiro; Tetteroo, Marieke
2012-07-01
The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. The descriptive study included reflective reports and one-on-one discussions over a 3-year period. With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. © 2011 Wiley Periodicals, Inc.
Mazidi, Mohammad; Ostovar, Soghra
2006-08-01
This study was designed to assess the effects of religion and two types of religious internalization on the mental health of Iranian adolescents. High school students (82 Moslem and 37 Christian) were selected randomly from four high schools in Shiraz and completed the Religious Self-regulation Questionnaire and the General Health Questionnaire. Analysis showed that main effects of types of religious internalization measured on four subscales of the General Health Questionnaire were significant. Religion was significantly associated only with somatic symptoms. For other scales no main effects of religion, types of religious internalization, or their interactions were significant.
Barnes, David M.; Meyer, Ilan H.
2012-01-01
Most religious environments in the U.S. do not affirm homosexuality. We investigate the relationship between exposure to non-affirming religious environments and internalized homophobia and mental health in a sample of LGBs in New York City. Guided by minority stress theory, we hypothesized that exposure to non-affirming religious settings would lead to higher internalized homophobia, more depressive symptoms, and less psychological well-being. We hypothesized that Black and Latino LGBs would be more likely than White LGBs to participate in non-affirming religious settings and would therefore have higher internalized homophobia than White LGBs. Participants were 355 LGBs recruited through community-based venue sampling and evenly divided between Black, Latino, and White race/ethnic groups, and between women and men and age groups within each race/ethnic group. Results supported our general hypothesis that non-affirming religion was associated with higher internalized homophobia. There was no main effect of non-affirming religion on mental health, an unexpected finding we discuss. Latinos, but not Blacks, had higher internalized homophobia than Whites and, as predicted, this was mediated by their greater exposure to non-affirming religion. PMID:23039348
Barnes, David M; Meyer, Ilan H
2012-10-01
Most religious environments in the United States do not affirm homosexuality. The authors investigated the relationship between exposure to nonaffirming religious environments and internalized homophobia and mental health in a sample of lesbians, gay men, and bisexuals (LGBs) in New York City. Guided by minority stress theory, the authors hypothesized that exposure to nonaffirming religious settings would lead to higher internalized homophobia, more depressive symptoms, and less psychological well-being. The authors hypothesized that Black and Latino LGBs would be more likely than White LGBs to participate in nonaffirming religious settings and would therefore have higher internalized homophobia than White LGBs. Participants were 355 LGBs recruited through community-based venue sampling and evenly divided among Black, Latino, and White race or ethnic groups and among age groups within each race or ethnic group, as well as between women and men. Results supported the general hypothesis that nonaffirming religion was associated with higher internalized homophobia. There was no main effect of nonaffirming religion on mental health, an unexpected finding discussed in this article. Latinos, but not Blacks, had higher internalized homophobia than Whites, and as predicted, this was mediated by their greater exposure to nonaffirming religion. © 2012 American Orthopsychiatric Association.
DiGirolamo, Ann M; Ramirez-Zea, Manuel; Wang, Meng; Flores-Ayala, Rafael; Martorell, Reynaldo; Neufeld, Lynnette M; Ramakrishnan, Usha; Sellen, Daniel; Black, Maureen M; Stein, Aryeh D
2010-01-01
Background: Rates of mental illness in children are increasing throughout the world. Observational studies of depression, anxiety, and attention-deficit hyperactivity disorder suggest that zinc is an alternative treatment. Objective: We examined the effect of zinc supplementation on the mental health of school-age children in Guatemala. Design: From January to October 2006, we conducted a 6-mo randomized, double-blind, controlled trial comparing zinc supplementation (10 mg ZnO/d for 5 d/wk) with a placebo (10 mg glucose) in 674 Guatemalan children in grades 1–4. Outcome measures included internalizing (ie, depression and anxiety) and externalizing (ie, hyperactivity and conduct disorder) problem behaviors, positive behaviors (ie, socialization and leadership), and serum zinc concentrations. Results: Zinc and placebo groups did not differ significantly in any behavioral measures at baseline or at follow-up. At baseline, 21.4% of children had serum zinc concentrations <65 μg/dL. At follow-up, both groups improved significantly, and zinc concentrations were higher in the zinc group. Increases in serum zinc concentrations were inversely associated with decreases in depressive symptoms (estimate: −0.01 points per μg Zn/dL; P = 0.01), anxiety (estimate: −0.012 points per μg Zn/dL; P = 0.02), internalizing symptoms (estimate: −0.021 points per μg Zn/dL; P = 0.02), and social skills (estimate: −0.019 points per μg Zn/dL; P = 0.01) in adjusted models that were controlled for child age, sex, socioeconomic status, household, and treatment group. Conclusions: Six months of zinc supplementation did not induce differences in mental health outcomes between zinc and placebo groups. However, increases in serum zinc concentrations were associated with decreases in internalizing symptoms (ie, depression and anxiety) in a community-based sample of children at risk of zinc deficiency. This trial was registered at clinicaltrials.gov as NCT00283660. PMID:20881069
Weight bias internalization, core self-evaluation, and health in overweight and obese persons.
Hilbert, Anja; Braehler, Elmar; Haeuser, Winfried; Zenger, Markus
2014-01-01
Weight bias has strong associations with psychopathology in overweight and obese individuals. However, self-evaluative processes, as conceptualized in the process model of self-stigma, and implications for other health-related outcomes, remain to be clarified. In a representative general population sample of N = 1158 overweight and obese individuals, the impact of core self-evaluation as a mediator between weight bias internalization and mental and global health outcomes as well as between weight bias internalization and health care utilization, was examined using structural equation modeling. In overweight and obese individuals, greater weight bias internalization predicted lower core self-evaluation, which in turn predicted greater depression and anxiety, lower global health, and greater health care utilization. These mediational associations were largely stable in subsample analyses and after controlling for sociodemographic variables. The results show that overweight and obese individuals with internalized weight bias are at risk for impaired health, especially if they experience low core self-evaluation, making them a group with which to target for interventions to reduce self-stigma. Weight bias internalization did not represent a barrier to health care utilization, but predicted greater health care utilization in association with greater health impairments. Copyright © 2013 The Obesity Society.
Siegenthaler, Eliane; Munder, Thomas; Egger, Matthias
2012-01-01
Mental illness in parents affects the mental health of their children. A systematic review and a meta-analysis of the effectiveness of interventions to prevent mental disorders or psychological symptoms in the offspring were performed. The Cochrane, MEDLINE, EMBASE, and PsycINFO databases were searched for randomized controlled trials of interventions in parents with mental disorders. Outcomes in the child included incident mental disorders of the same nature and internalizing (negative emotions, depressive symptoms, anxiety) or externalizing (hyperactivity, aggressiveness, behavioral problems) symptoms. Relative risks and standardized mean differences in symptom scores were combined in random-effects meta-analysis. Thirteen trials including 1,490 children were analyzed. Interventions included cognitive, behavioral, or psychoeducational components. Seven trials assessed the incidence of mental disorders and seven trials assessed symptoms. In total 161 new diagnoses of mental illness were recorded, with interventions decreasing the risk by 40% (combined relative risk 0.60, 95% CI 0.45-0.79). Symptom scores were lower in the intervention groups: standardized mean differences were -0.22 (95% CI -0.37 to -0.08) for internalizing symptoms (p = .003) and -0.16 (95% confidence interval -0.36 to 0.04) for externalizing symptoms (p = .12). Interventions to prevent mental disorders and psychological symptoms in the offspring of parents with mental disorders appear to be effective. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
McCloughen, Andrea; Foster, Kim; Huws-Thomas, Michelle; Delgado, Cynthia
2012-06-01
Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
2006-01-01
Background An increasing proportion of immigrants to Western countries in the past decade are from war affected countries. The aim of this study was to estimate the prevalence of war experience among adolescents and their parents and to investigate possible differences in internalizing and externalizing mental health problems between adolescents exposed and unexposed to own and parental war experience. Method The study is based on a cross-sectional population-based survey of all 10th grade pupils in Oslo for two consecutive years. A total of 1,758 aadolescents were included, all with both parents born outside of Norway. Internalizing and externalizing mental health problems were measured by Hopkins Symptom Checklist-10 and subscales of the Strengths and Difficulties Questionnaire, respectively. Own and parental war experience is based on adolescent self-report. Results The proportion of adolescents with own war experience was 14% with the highest prevalence in immigrants from Eastern Europe and Sub-Saharan Africa. The proportion of parental war experience was 33% with Sub-Saharan Africa being highest. Adolescents reporting own war experience had higher scores for both internalizing and externalizing mental health problems compared to immigrants without war experience, but only externalizing problems reached statistically significant differences. For parental war experience there was a statistically significant relationship between parental war experience and internalizing mental health problems. The association remained significant after adjustment for parental educational level and adolescents' own war experience. Conclusion War exposure is highly prevalent among immigrants living in Oslo, Norway, both among adolescents themselves and their parents. Among immigrants to Norway, parental war experience appears to be stronger associated with mental health problems than adolescents own exposure to war experience. PMID:17081315
Dimensional psychiatry: mental disorders as dysfunctions of basic learning mechanisms.
Heinz, Andreas; Schlagenhauf, Florian; Beck, Anne; Wackerhagen, Carolin
2016-08-01
It has been questioned that the more than 300 mental disorders currently listed in international disease classification systems all have a distinct neurobiological correlate. Here, we support the idea that basic dimensions of mental dysfunctions, such as alterations in reinforcement learning, can be identified, which interact with individual vulnerability and psychosocial stress factors and, thus, contribute to syndromes of distress across traditional nosological boundaries. We further suggest that computational modeling of learning behavior can help to identify specific alterations in reinforcement-based decision-making and their associated neurobiological correlates. For example, attribution of salience to drug-related cues associated with dopamine dysfunction in addiction can increase habitual decision-making via promotion of Pavlovian-to-instrumental transfer as indicated by computational modeling of the effect of Pavlovian-conditioned stimuli (here affectively positive or alcohol-related cues) on instrumental approach and avoidance behavior. In schizophrenia, reward prediction errors can be modeled computationally and associated with functional brain activation, thus revealing reduced encoding of such learning signals in the ventral striatum and compensatory activation in the frontal cortex. With respect to negative mood states, it has been shown that both reduced functional activation of the ventral striatum elicited by reward-predicting stimuli and stress-associated activation of the hypothalamic-pituitary-adrenal axis in interaction with reduced serotonin transporter availability and increased amygdala activation by aversive cues contribute to clinical depression; altogether these observations support the notion that basic learning mechanisms, such as Pavlovian and instrumental conditioning and Pavlovian-to-instrumental transfer, represent a basic dimension of mental disorders that can be mechanistically characterized using computational modeling and associated with specific clinical syndromes across established nosological boundaries. Instead of pursuing a narrow focus on single disorders defined by clinical tradition, we suggest that neurobiological research should focus on such basic dimensions, which can be studied in and compared among several mental disorders.
Kolko, David J; Perrin, Ellen
2014-01-01
Because the integration of mental or behavioral health services in pediatric primary care is a national priority, a description and evaluation of the interventions applied in the healthcare setting is warranted. This article examines several intervention research studies based on alternative models for delivering behavioral health care in conjunction with comprehensive pediatric care. This review describes the diverse methods applied to different clinical problems, such as brief mental health skills, clinical guidelines, and evidence-based practices, and the empirical outcomes of this research literature. Next, several key treatment considerations are discussed to maximize the efficiency and effectiveness of these interventions. Some practical suggestions for overcoming key service barriers are provided to enhance the capacity of the practice to deliver behavioral health care. There is moderate empirical support for the feasibility, acceptability, and clinical utility of these interventions for treating internalizing and externalizing behavior problems. Practical strategies to extend this work and address methodological limitations are provided that draw upon recent frameworks designed to simplify the treatment enterprise (e.g., common elements). Pediatric primary care has become an important venue for providing mental health services to children and adolescents due, in part, to its many desirable features (e.g., no stigma, local setting, familiar providers). Further adaptation of existing delivery models may promote the delivery of effective integrated interventions with primary care providers as partners designed to address mental health problems in pediatric healthcare.
[Mentally ill and dangerous: civil commitment or internment? The Belgian judicial framework].
Smets, H; Verelst, R; Vandenberghe, J
2009-01-01
There are two important Belgian laws referring to psychiatric disturbances that may prove dangerous. The Civil Code includes the law relating to the protection of the mentally ill person, dated 26th June 1990, better known as the law of civil commitment of the mentally ill. Since April, 2007, the Penal Code has contained a new law on the internment of people with a psychiatric disorder; this new law replaces the old law of the 1st July, 1964, meant to protect the society. Although the two laws apply to different fields, in clinical practice there are sometimes 'grey areas' where it is not immediately evident which legal framework is applicable. Starting from a case study in which the civil judge ordered the civil commitment of a detainee, we explore these 'grey areas' and compare the two legal frameworks. We base our study on the new law on internment, clarify it and sketch the legal history of internment in Belgium.
Peer work in Open Dialogue: A discussion paper.
Bellingham, Brett; Buus, Niels; McCloughen, Andrea; Dawson, Lisa; Schweizer, Richard; Mikes-Liu, Kristof; Peetz, Amy; Boydell, Katherine; River, Jo
2018-03-25
Open Dialogue is a resource-oriented approach to mental health care that originated in Finland. As Open Dialogue has been adopted across diverse international healthcare settings, it has been adapted according to contextual factors. One important development in Open Dialogue has been the incorporation of paid, formal peer work. Peer work draws on the knowledge and wisdom gained through lived experience of distress and hardship to establish mutual, reciprocal, and supportive relationships with service users. As Open Dialogue is now being implemented across mental health services in Australia, stakeholders are beginning to consider the role that peer workers might have in this model of care. Open Dialogue was not, initially, conceived to include a specific role for peers, and there is little available literature, and even less empirical research, in this area. This discussion paper aims to surface some of the current debates and ideas about peer work in Open Dialogue. Examples and models of peer work in Open Dialogue are examined, and the potential benefits and challenges of adopting this approach in health services are discussed. Peer work in Open Dialogue could potentially foster democracy and disrupt clinical hierarchies, but could also move peer work from reciprocal to a less symmetrical relationship of 'giver' and 'receiver' of care. Other models of care, such as lived experience practitioners in Open Dialogue, can be conceived. However, it remains uncertain whether the hierarchical structures in healthcare and current models of funding would support any such models. © 2018 Australian College of Mental Health Nurses Inc.
McLafferty, Margaret; Lapsley, Coral R.; Ennis, Edel; Armour, Cherie; Murphy, Sam; Bunting, Brendan P.; Bjourson, Anthony J.; O'Neill, Siobhan M.
2017-01-01
Mental health and behavioural problems are common among students commencing university. University life can be stressful and problems often exacerbate during their course of study, while others develop disorders for the first time. The WHO World Mental Health Surveys International College Student Project aims to conduct longitudinal research to examine and monitor student mental health and wellbeing. The Ulster University Student Wellbeing study, which commenced in September 2015 in Northern Ireland (NI), was conducted as part of this initiative (wave 1, n = 739), using the WMH-CIDI to examine psychopathology. Baseline prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality were high, with more than half of new undergraduate students reporting any lifetime disorder. Co-morbidity was common with 19.1% of students experiencing three or more disorders. Logistic regression models revealed that females, those over 21, non-heterosexual students, and those from a lower SES background were more likely to have a range of mental health and behavioural problems. Overall, 10% of new entry students received treatment for emotional problems in the previous year. However, 22.3% of students with problems said they would not seek help. The study provides important information for universities, policy makers and practice, on mental health and wellbeing in young people generally but particularly for students commencing university. The findings will assist in the development and implementation of protection and prevention strategies in the university setting and beyond. PMID:29236727
Perspectives on perceived stigma and self-stigma in adult male patients with depression.
Latalova, Klara; Kamaradova, Dana; Prasko, Jan
2014-01-01
There are two principal types of stigma in mental illness, ie, "public stigma" and "self-stigma". Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is "self-stigma". Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms ("boys don't cry") leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men's feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional.
McLafferty, Margaret; Lapsley, Coral R; Ennis, Edel; Armour, Cherie; Murphy, Sam; Bunting, Brendan P; Bjourson, Anthony J; Murray, Elaine K; O'Neill, Siobhan M
2017-01-01
Mental health and behavioural problems are common among students commencing university. University life can be stressful and problems often exacerbate during their course of study, while others develop disorders for the first time. The WHO World Mental Health Surveys International College Student Project aims to conduct longitudinal research to examine and monitor student mental health and wellbeing. The Ulster University Student Wellbeing study, which commenced in September 2015 in Northern Ireland (NI), was conducted as part of this initiative (wave 1, n = 739), using the WMH-CIDI to examine psychopathology. Baseline prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality were high, with more than half of new undergraduate students reporting any lifetime disorder. Co-morbidity was common with 19.1% of students experiencing three or more disorders. Logistic regression models revealed that females, those over 21, non-heterosexual students, and those from a lower SES background were more likely to have a range of mental health and behavioural problems. Overall, 10% of new entry students received treatment for emotional problems in the previous year. However, 22.3% of students with problems said they would not seek help. The study provides important information for universities, policy makers and practice, on mental health and wellbeing in young people generally but particularly for students commencing university. The findings will assist in the development and implementation of protection and prevention strategies in the university setting and beyond.
Murdoch, Maureen; Spoont, Michele Roxanne; Kehle-Forbes, Shannon Marie; Harwood, Eileen Mae; Sayer, Nina Aileen; Clothier, Barbara Ann; Bangerter, Ann Kay
2017-02-01
Millions of U.S. veterans have returned from military service with posttraumatic stress disorder (PTSD), for which a substantial number receive U.S. Department of Veterans Affairs (VA) disability benefits. Although PTSD is treatable, comorbid serious mental illness (defined here as schizophrenia, schizoaffective disorder, and bipolar spectrum disorders) could complicate these veterans' recovery. Using VA administrative data, we examined the burden of persistent serious mental illness in a nationally representative cohort of 1,067 men and 1,513 women who applied for VA PTSD disability benefits between 1994 and 1998 and served during or after the Vietnam conflict. Self-reported outcomes were restricted to the 713 men and 1,015 women who returned surveys at each of 3 collection points. More than 10.0% of men and 20.0% of women had persistent serious mental illness; of these, more than 80.0% also had persistent PTSD. On repeated measures modeling, those with persistent serious mental illness consistently reported more severe PTSD symptoms and poorer functioning in comparison to other participants (ps < .001); their employment rate did not exceed 21.0%. Interactions between persistent serious mental illness and PTSD were significant only for employment (p = .002). Persistent serious mental illness in this population was almost 2 to 19 times higher than in the general U.S. The implications of these findings are discussed. Copyright © 2017 International Society for Traumatic Stress Studies.
Mental imagery of gravitational motion.
Gravano, Silvio; Zago, Myrka; Lacquaniti, Francesco
2017-10-01
There is considerable evidence that gravitational acceleration is taken into account in the interaction with falling targets through an internal model of Earth gravity. Here we asked whether this internal model is accessed also when target motion is imagined rather than real. In the main experiments, naïve participants grasped an imaginary ball, threw it against the ceiling, and caught it on rebound. In different blocks of trials, they had to imagine that the ball moved under terrestrial gravity (1g condition) or under microgravity (0g) as during a space flight. We measured the speed and timing of the throwing and catching actions, and plotted ball flight duration versus throwing speed. Best-fitting duration-speed curves estimate the laws of ball motion implicit in the participant's performance. Surprisingly, we found duration-speed curves compatible with 0g for both the imaginary 0g condition and the imaginary 1g condition, despite the familiarity with Earth gravity effects and the added realism of performing the throwing and catching actions. In a control experiment, naïve participants were asked to throw the imaginary ball vertically upwards at different heights, without hitting the ceiling, and to catch it on its way down. All participants overestimated ball flight durations relative to the durations predicted by the effects of Earth gravity. Overall, the results indicate that mental imagery of motion does not have access to the internal model of Earth gravity, but resorts to a simulation of visual motion. Because visual processing of accelerating/decelerating motion is poor, visual imagery of motion at constant speed or slowly varying speed appears to be the preferred mode to perform the tasks. Copyright © 2017 Elsevier Ltd. All rights reserved.
Kinesthetic imagery of musical performance
Lotze, Martin
2013-01-01
Musicians use different kinds of imagery. This review focuses on kinesthetic imagery, which has been shown to be an effective complement to actively playing an instrument. However, experience in actual movement performance seems to be a requirement for a recruitment of those brain areas representing movement ideation during imagery. An internal model of movement performance might be more differentiated when training has been more intense or simply performed more often. Therefore, with respect to kinesthetic imagery, these strategies are predominantly found in professional musicians. There are a few possible reasons as to why kinesthetic imagery is used in addition to active training; one example is the need for mental rehearsal of the technically most difficult passages. Another reason for mental practice is that mental rehearsal of the piece helps to improve performance if the instrument is not available for actual training as is the case for professional musicians when they are traveling to various appearances. Overall, mental imagery in musicians is not necessarily specific to motor, somatosensory, auditory, or visual aspects of imagery, but integrates them all. In particular, the audiomotor loop is highly important, since auditory aspects are crucial for guiding motor performance. All these aspects result in a distinctive representation map for the mental imagery of musical performance. This review summarizes behavioral data, and findings from functional brain imaging studies of mental imagery of musical performance. PMID:23781196
Kinesthetic imagery of musical performance.
Lotze, Martin
2013-01-01
Musicians use different kinds of imagery. This review focuses on kinesthetic imagery, which has been shown to be an effective complement to actively playing an instrument. However, experience in actual movement performance seems to be a requirement for a recruitment of those brain areas representing movement ideation during imagery. An internal model of movement performance might be more differentiated when training has been more intense or simply performed more often. Therefore, with respect to kinesthetic imagery, these strategies are predominantly found in professional musicians. There are a few possible reasons as to why kinesthetic imagery is used in addition to active training; one example is the need for mental rehearsal of the technically most difficult passages. Another reason for mental practice is that mental rehearsal of the piece helps to improve performance if the instrument is not available for actual training as is the case for professional musicians when they are traveling to various appearances. Overall, mental imagery in musicians is not necessarily specific to motor, somatosensory, auditory, or visual aspects of imagery, but integrates them all. In particular, the audiomotor loop is highly important, since auditory aspects are crucial for guiding motor performance. All these aspects result in a distinctive representation map for the mental imagery of musical performance. This review summarizes behavioral data, and findings from functional brain imaging studies of mental imagery of musical performance.
Gaziel, M; Hasson-Ohayon, I; Morag-Yaffe, M; Schapir, L; Zalsman, G; Shoval, G
2015-02-01
The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders. Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students' Life Satisfaction Scale (MSLSS) were administrated to 30 adolescent patients. Adapted version for parents of the SAI-E was also administrated to 37 of their parents. Significant positive correlations were found between insight into the illness, self-stigma and parental insight. Insight and self-stigma were significantly negatively related to the total score of SwL and few of its dimensions while parental insight was significantly associated only with the SwL dimensions of school and self. Regression models revealed main negative effects of insight and self-stigma on SwL and no interaction effect. The possible independent contribution of insight and self-stigma to SwL should be addressed in interventions designed for family and adolescents coping with mental illness. Special attention should be given to the possible negative implications that insight possesses. In lack of support of the moderation role of self-stigma, reported in studies among adults with mental illness, future studies should trace other variables in order to further understand the insight paradox among adolescents. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Cosma, Alina; Belić, Jelisaveta; Blecha, Ondřej; Fenski, Friederike; Lo, Man Y.; Murár, Filip; Petrovic, Darija; Stella, Maria T.
2017-01-01
The promotion of positive mental health is a becoming priority worldwide. Despite all the efforts invested in preventive and curative work, it is estimated that one in four persons will experience a mental health condition at some point in their lives. Even more worrying is the fact that up to a half of all mental health problems have their onset before the age of 14. Recent statistics (national and international surveys, meta-analyses, international reports) point out to the fact that child and adolescent mental health problems are on the rise. The present study will try to corroborate these results and further explore their meaning, by employing a sequential mixed methods research design (quantitative–qualitative). The quantitative part will analyze time trends using Health Behaviors in School-aged Children data (four survey cycles: 2002, 2006, 2010, 2014) on mental well-being from four European countries (the Czechia, Germany, Italy, and United Kingdom). The qualitative part will rely on focus groups to explore the perspectives of 13- and 15-year-old boys and girls on gender differences and on the changes in adolescent mental well-being over time, as well as measures through which these issues could be addressed. Thematic analysis will be employed to analyze qualitative data. The results of this study could make a major contribution to our understanding of the current trends in adolescent mental well-being, as well as the ways in which existing data could be linked to international and national health policies. PMID:28572776
Unwanted sexual experiences and cognitive appraisals that evoke mental contamination.
Ishikawa, Ryotaro; Kobori, Osamu; Shimizu, Eiji
2015-01-01
Mental contamination is a psychological sense of contamination that involves an internal, emotional feeling of dirtiness that may be evoked by unwanted thoughts and images, such as sexual assaults. This study aimed to investigate which types of unwanted sexual experiences evoke the strongest mental contamination, and to test the hypothesis that cognitive appraisals of an unwanted sexual experience predict indices of mental contamination (i.e. feeling of dirtiness, urge to wash, internal negative emotions, and external negative emotions). 148 female participants were asked to recall their most distressing unwanted sexual experiences. Indices of mental contamination and cognitive appraisals of the experience were then assessed. Our findings indicated that individuals recalling experiences related to rape felt more intense feelings of dirtiness than individuals recalling other types of unwanted sexual experience, such as verbal sexual assault, visual sexual assault, and forcible touching/frottage. In addition, hierarchical regression analyses demonstrated that a cognitive appraisal of perceived violation predicted all of the indices of mental contamination after controlling anxiety, depression, and fear of contact contamination. The present study demonstrated that an individual is at greatest risk of mental contamination if she has experienced rape/attempted rape, and if she makes a cognitive appraisal of violation regarding the incident.
Mental health of lesbian, gay, and bisexual youth: A developmental resiliency perspective
Mustanski, Brian; Newcomb, M.; Garofalo, R.
2011-01-01
Research suggests that lesbian, gay, and bisexual (LGB) youth are at increased risk for both victimization and internalizing mental health problems, but limited research has studied their association or factors that increase resilience. The sample included 425 LGBs between the ages of 16 and 24 year. The majority had disclosed their sexual orientation to family or friends (98%) and 97% had someone in their lives who was accepting. Racial/ethnic minority and female participants in general reported lower levels of disclosure and acceptance. Most participants reported some form of sexual orientation-related victimization (94%). Victimization was associated with psychological distress, but a compensatory model indicated that in the context of this victimization both peer and family support had significant promotive effects. A test of a protective model found social support did not ameliorate negative effects of victimization. The positive effects of family support decreased with age. Peer and family support were particularly important, but they did not significantly dampen the negative effects of victimization. Our findings suggest that mental health professionals working with LGB youth should address social support and that public health approaches are needed to reduce levels of victimization. PMID:21731405
Cooper, Rachel
2017-08-01
In this article, I compare and evaluate R. D. Laing and A. Esterson's account of schizophrenia as developed in Sanity, Madness and the Family (1964), social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders (schizophrenia, disability, certain mental disorders) should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems (to be located in the family, or in the material and social environment). In this article, I consider the grounds on which such claims might be supported. I argue that problems should not be located within an individual putative patient in cases where there is some acceptable test environment in which there is no problem. A number of cases where such an argument can show that there is no internal disorder are discussed. I argue, however, that Laing and Esterson's argument-that schizophrenia is not within diagnosed patients-does not work. The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment.
Continuities of Risk in the Era of the Mental Capacity Act.
Fanning, John
2016-01-01
When compared with the Mental Capacity Act (MCA) 2005, the Mental Health Act (MHA) 1983 seems an outlier. It authorises compulsory treatment of mental disorders on the basis of P's risks. English law, therefore, discriminates between mental and physical disorders. Following the UK's ratification of the Convention on the Rights of Persons with Disabilities (CRPD), the MHA probably also violates international law. Against this backdrop, one might expect that decisions contingent on risk are confined to the MHA and have no relevance elsewhere. This article argues that the opposite is true: risk-based decision-making has colonised MCA processes and plays a key role in determining the nature of P's interaction with health services. These 'continuities' of risk are most notable in the Deprivation of Liberty Safeguards (DOLS), where assessments of risk are implicitly significant for best interests and eligibility determinations. Using governmentality theory as an explanatory model, this article claims that the DOLS can be reconstructed as part of a wider legal apparatus for the regulation of the risks of harm associated with mental disorders. The article also argues that the Law Commission's recent proposals to introduce a new 'protective care' scheme and expand the remit of the MHA hint at a 'rehabilitation' of risk as an integral component of mental health and capacity law. The article concludes that the concept's stigmatising potential, lack of definition, and conflict with the CRPD cast doubt on its capacity to reconcile English mental health law with the era of autonomy, capacity, and non-discrimination. © The Author 2016. Published by Oxford University Press.
Continuities of Risk in the Era of the Mental Capacity Act
2016-01-01
When compared with the Mental Capacity Act (MCA) 2005, the Mental Health Act (MHA) 1983 seems an outlier. It authorises compulsory treatment of mental disorders on the basis of P’s risks. English law, therefore, discriminates between mental and physical disorders. Following the UK’s ratification of the Convention on the Rights of Persons with Disabilities (CRPD), the MHA probably also violates international law. Against this backdrop, one might expect that decisions contingent on risk are confined to the MHA and have no relevance elsewhere. This article argues that the opposite is true: risk-based decision-making has colonised MCA processes and plays a key role in determining the nature of P’s interaction with health services. These ‘continuities’ of risk are most notable in the Deprivation of Liberty Safeguards (DOLS), where assessments of risk are implicitly significant for best interests and eligibility determinations. Using governmentality theory as an explanatory model, this article claims that the DOLS can be reconstructed as part of a wider legal apparatus for the regulation of the risks of harm associated with mental disorders. The article also argues that the Law Commission’s recent proposals to introduce a new ‘protective care’ scheme and expand the remit of the MHA hint at a ‘rehabilitation’ of risk as an integral component of mental health and capacity law. The article concludes that the concept’s stigmatising potential, lack of definition, and conflict with the CRPD cast doubt on its capacity to reconcile English mental health law with the era of autonomy, capacity, and non-discrimination. PMID:28007811
Breyer, Benjamin N; Cohen, Beth E; Bertenthal, Daniel; Rosen, Raymond C; Neylan, Thomas C; Seal, Karen H
2014-01-01
Mental health disorders are prevalent in the United States, Iraq, and Afghanistan war veterans. Mental illness, including posttraumatic stress disorder (PTSD) with or without psychiatric medications, can increase the risk for male sexual dysfunction, threatening quality of life. We sought to determine the prevalence and correlates of sexual dysfunction among male Iraq and Afghanistan veterans. We performed a retrospective cohort study of 405,275 male Iraq and Afghanistan veterans who were new users of U.S. Department of Veterans Affairs healthcare from October 7, 2001 to September 30, 2009 and had 2-year follow-up. We determined the independent association of mental health diagnoses and sexual dysfunction after adjusting for sociodemographic and military service characteristics, comorbidities, and medications. Veterans with PTSD were more likely to have a sexual dysfunction diagnosis, be prescribed medications for sexual dysfunction, or both (10.6%), compared with veterans having a mental diagnosis other than PTSD (7.2%), or no mental health diagnosis (2.3%). In a fully adjusted model, PTSD increased the risk of sexual dysfunction by more than threefold (adjusted risk ratio = 3.61, 95% CI = 3.48-3.75). Veterans with mental health disorders, particularly PTSD, were at the highest risk of sexual dysfunction when prescribed psychiatric medications (adjusted risk ratio = 4.59, 95% CI = 4.41-4.77). Among U.S. combat veterans, mental health disorders, particularly PTSD, increased the risk of sexual dysfunction independent of the use of psychiatric medications. © 2013 International Society for Sexual Medicine.
Semrau, M; Alem, A; Abdulmalik, J; Docrat, S; Evans-Lacko, S; Gureje, O; Kigozi, F; Lempp, H; Lund, C; Petersen, I; Shidhaye, R; Thornicroft, G; Hanlon, C
2018-02-01
There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the 'Emerging mental health systems in low- and middle-income countries' (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.
Determinants of health-related quality of life in international graduate students.
Ogunsanya, Motolani E; Bamgbade, Benita A; Thach, Andrew V; Sudhapalli, Poojee; Rascati, Karen L
2018-04-01
International graduate students often experience additional levels of stress due to acculturation. Given the impact of stress on health outcomes (both physical and mental), this study examined the health-related quality of life (HRQoL) in international graduate students to determine its association with acculturative stress, perceived stress, and use of coping mechanisms. A cross-sectional, self-administered survey was designed and sent to 38 student chapters within the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) student network. HRQoL [physical component summary (PCS) and mental component summary (MCS)] was measured using the 12-item Short Form (SF-12) while coping mechanisms were assessed using the Brief COPE Scale. Acculturative and perceived stress were assessed using the Acculturative Stress Scale for International students [ASSIS] and Graduate Stress Inventory-Revised (GSI-R), respectively. Demographic and personal information (e.g. age, religion) were also collected. Descriptive statistics (mean ± SD and frequency) and hierarchical multiple regression analysis were conducted. The average PCS and MCS were 60 ± 9 and 44 ± 13, respectively, indicating that while the physical health was above the United States (US) general population norm (50), mental health scores were lower. Findings from the hierarchical multiple regression showed that perceived and acculturative stress significantly predicted mental health. Acculturative stress was also a significant predictor of physical health. The results from this study support the hypothesis that international students in the US experience both perceived and acculturative stress that significantly impacts their HRQoL. Universities should consider providing education on stress reduction techniques to improve the health of international graduate students. Copyright © 2018 Elsevier Inc. All rights reserved.
Mullen, Richard; Faull, Andrea; Jones, Eleri S; Kingston, Kieran
2012-01-01
Previous studies have demonstrated that an external focus can enhance motor learning compared to an internal focus. The benefits of adopting an external focus are attributed to the use of less effortful automatic control processes, while an internal focus relies upon more effort-intensive consciously controlled processes. The aim of this study was to compare the effectiveness of a distal external focus with an internal focus in the acquisition of a simulated driving task and subsequent performance in a competitive condition designed to increase state anxiety. To provide further evidence for the automatic nature of externally controlled movements, the study included heart rate variability (HRV) as an index of mental effort. Sixteen participants completed eight blocks of four laps in either a distal external or internal focus condition, followed by two blocks of four laps in the competitive condition. During acquisition, the performance of both groups improved; however, the distal external focus group outperformed the internal focus group. The poorer performance of the internal focus group was accompanied by a larger reduction in HRV, indicating a greater investment of mental effort. In the competition condition, state anxiety increased, and for both groups, performance improved as a function of the increased anxiety. Increased heart rate and self-reported mental effort accompanied the performance improvement. The distal external focus group also outperformed the internal focus group across both neutral and competitive conditions and this more effective performance was again associated with lower levels of HRV. Overall, the results offer support for the suggestion that an external focus promotes a more automatic mode of functioning. In the competitive condition, both foci enhanced performance and while the improved performance may have been achieved at the expense of greater compensatory mental effort, this was not reflected in HRV scores.
Identifying Students with Mental Health Issues: A Guide for Classroom Teachers
ERIC Educational Resources Information Center
Marsh, Robbie J.
2016-01-01
Child and adolescent mental health is a growing concern in schools. Students suffering from mental health conditions struggle in the school environment if their needs are not being met. Teachers play an important role in the identification of these students. This article highlights the distinctions between externalizing and internalizing behaviors…
ERIC Educational Resources Information Center
O'Hare, Thomas; Sherrer, Margaret V.; LaButti, Annamaria; Emrick, Kelly
2004-01-01
Objective/Method: The use of brief, reliable, valid, and practical measures of substance use is critical for conducting individual assessments and program evaluation for integrated mental health-substance abuse services for persons with serious mental illness. This investigation examines the internal consistency reliability, concurrent validity,…
Overview of Current Trends in Mental Health Problems for Australia's Youth and Adolescents
ERIC Educational Resources Information Center
Rickwood, Debra; White, Angela; Eckersley, Richard
2007-01-01
This paper provides an overview of current trends in the mental health problems of Australia's youth and adolescents. It presents information derived from the most recent and comprehensive Australian surveys of youth mental health, and provides international comparisons and views from professional practice where relevant. An update of trends for…
Mental Health Stigma: Society, Individuals, and the Profession
Ahmedani, Brian K.
2011-01-01
Mental health stigma operates in society, is internalized by individuals, and is attributed by health professionals. This ethics-laden issue acts as a barrier to individuals who may seek or engage in treatment services. The dimensions, theory, and epistemology of mental health stigma have several implications for the social work profession. PMID:22211117
Unfurling the Wings of Flight: Clarifying "The What" and "The Why" of Mental Imagery Use in Dance
ERIC Educational Resources Information Center
Fisher, Vicky J.
2017-01-01
This article provides clarification regarding "the what" and "the why" of mental imagery use in dance. It proposes that mental images are invoked across sensory modalities and often combine internal and external perspectives. The content of images ranges from "direct" body oriented simulations along a continuum…
Code of Federal Regulations, 2012 CFR
2012-07-01
... dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and replacement; (4...,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12 months, but not to exceed $5,000...
Code of Federal Regulations, 2014 CFR
2014-07-01
..., including dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and... would be appropriate Up to $50,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12...
Code of Federal Regulations, 2013 CFR
2013-07-01
..., including dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and... would be appropriate Up to $50,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12...
Code of Federal Regulations, 2010 CFR
2010-07-01
... dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and replacement; (4...,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12 months, but not to exceed $5,000...
Code of Federal Regulations, 2011 CFR
2011-07-01
... dental and rehabilitation costs; (2) Mental health care; (3) Property loss, repair, and replacement; (4...,000. Mental health care Victim's (and, when victim is a minor, incompetent, incapacitated, or deceased, certain family members') mental health counseling costs Up to 12 months, but not to exceed $5,000...
NASA Astrophysics Data System (ADS)
Sarif; Kurauchi, Shinya; Yoshii, Toshio
2017-06-01
In the conventional travel behavior models such as logit and probit, decision makers are assumed to conduct the absolute evaluations on the attributes of the choice alternatives. On the other hand, many researchers in cognitive psychology and marketing science have been suggesting that the perceptions of attributes are characterized by the benchmark called “reference points” and the relative evaluations based on them are often employed in various choice situations. Therefore, this study developed a travel behavior model based on the mental accounting theory in which the internal reference points are explicitly considered. A questionnaire survey about the shopping trip to the CBD in Matsuyama city was conducted, and then the roles of reference points in travel mode choice contexts were investigated. The result showed that the goodness-of-fit of the developed model was higher than that of the conventional model, indicating that the internal reference points might play the major roles in the choice of travel mode. Also shown was that the respondents seem to utilize various reference points: some tend to adopt the lowest fuel price they have experienced, others employ fare price they feel in perceptions of the travel cost.
Schlack, Robert; Petermann, Franz
2013-07-02
Research examining mental health in violence-affected youth in representative samples is rare. Using data from the nationally representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) this study reports on gender-specific prevalence rates and associations of a broad range of internalizing and externalizing mental health problems: emotional problems, conduct problems, ADHD, disordered eating, somatic pain and substance use in youth variously affected by violence. While internalizing is generally more common in girls and externalizing in boys, observations of prior non-normative studies suggest reverse associations once an individual is affected by violence. The occurrence of such "gender cross-over effects" is therefore examined in a representative sample. The sample consisted of 6,813 adolescents aged 11 to 17 from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Applying multivariate logistic regression analyses, associations between each type of violence history and mental health indicator were determined for perpetrators, victims, and perpetrating victims of youth violence. Moderating effects of gender were examined by using product term interaction. Victim status was associated primarily with internalizing problems, while perpetrators were more prone to externalizing problems. Perpetrating victims stood out with respect to the number and strength of risk associations with all investigated mental health indicators. However, the risk profiles of all violence-affected youth included both internalizing and externalizing mental health problems. Gender cross-over effects were found for girls and boys: despite lower overall prevalence, girls affected by violence were at far higher risk for conduct problems and illicit drug use; by contrast, somatic pain, although generally lower in males, was positively associated with perpetrator status and perpetrating victim status in boys. All violence-affected youth exhibited significantly higher rates of cumulative mental health problems. The results highlight the importance of violence for the mental health of youth. They reveal a particular vulnerability as a function of gender. Implications for policy making, clinical practice and research are discussed.
2013-01-01
Background Research examining mental health in violence-affected youth in representative samples is rare. Using data from the nationally representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) this study reports on gender-specific prevalence rates and associations of a broad range of internalizing and externalizing mental health problems: emotional problems, conduct problems, ADHD, disordered eating, somatic pain and substance use in youth variously affected by violence. While internalizing is generally more common in girls and externalizing in boys, observations of prior non-normative studies suggest reverse associations once an individual is affected by violence. The occurrence of such “gender cross-over effects” is therefore examined in a representative sample. Methods The sample consisted of 6,813 adolescents aged 11 to 17 from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Applying multivariate logistic regression analyses, associations between each type of violence history and mental health indicator were determined for perpetrators, victims, and perpetrating victims of youth violence. Moderating effects of gender were examined by using product term interaction. Results Victim status was associated primarily with internalizing problems, while perpetrators were more prone to externalizing problems. Perpetrating victims stood out with respect to the number and strength of risk associations with all investigated mental health indicators. However, the risk profiles of all violence-affected youth included both internalizing and externalizing mental health problems. Gender cross-over effects were found for girls and boys: despite lower overall prevalence, girls affected by violence were at far higher risk for conduct problems and illicit drug use; by contrast, somatic pain, although generally lower in males, was positively associated with perpetrator status and perpetrating victim status in boys. All violence-affected youth exhibited significantly higher rates of cumulative mental health problems. Conclusions The results highlight the importance of violence for the mental health of youth. They reveal a particular vulnerability as a function of gender. Implications for policy making, clinical practice and research are discussed. PMID:23819775
The development and maintenance of mental toughness: perceptions of elite performers.
Connaughton, Declan; Wadey, Ross; Hanton, Sheldon; Jones, Graham
2008-01-01
Seven participants from a previous study (Jones, Hanton, & Connaughton, 2002) agreed to be interviewed about the development of mental toughness. We also aimed to determine whether mental toughness requires maintenance. Semistructured interviews were conducted to elicit the participants' perceptions of how mental toughness is cultivated and retained. Findings indicated that the development of mental toughness is a long-term process that encompasses a multitude of underlying mechanisms that operate in a combined, rather than independent, fashion. In general, these perceived underlying mechanisms related to many features associated with a motivational climate (e.g. enjoyment, mastery), various individuals (i.e. coaches, peers, parents, grandparents, siblings, senior athletes, sport psychologists, team-mates), experiences in and outside sport, psychological skills and strategies, and an insatiable desire and internalized motives to succeed. It was also reported that once mental toughness had been developed, three perceived underlying mechanisms were required to maintain this construct: a desire and motivation to succeed that was insatiable and internalized, a support network that included sporting and non-sporting personnel, and effective use of basic and advanced psychological skills. Practical implications and future avenues of research are discussed.
NASA Technical Reports Server (NTRS)
Mitchell, Diane Kuhl; Wojciechowski, Josephine; Samms, Charneta
2012-01-01
A challenge facing the U.S. National Highway Traffic Safety Administration (NHTSA), as well as international safety experts, is the need to educate car drivers about the dangers associated with performing distraction tasks while driving. Researchers working for the U.S. Army Research Laboratory have developed a technique for predicting the increase in mental workload that results when distraction tasks are combined with driving. They implement this technique using human performance modeling. They have predicted workload associated with driving combined with cell phone use. In addition, they have predicted the workload associated with driving military vehicles combined with threat detection. Their technique can be used by safety personnel internationally to demonstrate the dangers of combining distracter tasks with driving and to mitigate the safety risks.
Galovski, Tara E; Peterson, Zoë D; Beagley, Marin C; Strasshofer, David R; Held, Philip; Fletcher, Thomas D
2016-08-01
There is little information available on the mental health effects of exposure to shared community violence such as the August 2014 violence that occurred in Ferguson, Missouri. This study sought to examine the relationship between proximity to community violence and mental health in both community members and police officers. We recruited 565 adults (community, n = 304, and police, n = 261) exposed to the violence in Ferguson to complete measures of proximity to violence, posttraumatic stress, depression, and anger. Using structural equation modeling, we assessed aspects of proximity to violence-connectedness, direct exposure, fear from exposure, media exposure, reactions to media, and life interruption-as correlates of posttraumatic stress disorder (PTSD) symptoms, depression, and anger. The final model yielded (n = 432), χ(2) (d = 12) = 7.4, p = .830; comparative fit index = 1.0, root mean square error of approximation = 0 [0, .04]. All aspects of proximity except direct exposure were associated with mental health outcomes. There was no moderation as a function of community versus police. Race moderated the relationship between life interruptions and negative outcomes; interruption was related to distress for White, but not Black community members. Based on group comparisons, community members reported more symptoms of PTSD and depression than law enforcement (ηp (2) = .06 and .02, respectively). Black community members reported more PTSD and depression than White community members (ηp (2) = .05 and .02, respectively). Overall, distress was high, and mental health interventions are likely indicated for some individuals exposed to the Ferguson events. Copyright © 2016 International Society for Traumatic Stress Studies.
Gavazzi, Stephen M; Bostic, Jennifer M; Lim, Ji-Young; Yarcheck, Courtney M
2008-07-01
Faced with anywhere between one half and two thirds of its youth having a diagnosable mental illness, the identification and treatment of mental health concerns is a critically important endeavor for professionals working with youth who have contact with the juvenile justice system. In addition, the literature suggests that factors related to both the family and to the gender of the adolescent must be incorporated into any approach to assessment and intervention within this special population. Further, prior work that has documented the interaction of gender and family issues with adolescent race/ethnicity warrants further empirical attention, as does the intermediary role that the family may play in the development of both internalizing and externalizing behaviors. The present study extends this literature by examining factors related to gender, race/ethnicity, family factors, and mental health issues in a sample of 2,549 Caucasian and African American youth coming to the attention of juvenile courts. Multivariate analysis of variance results indicated significant main effects for gender and race/ethnicity, as well as a significant gender x race/ethnicity interaction for the family and externalizing variables. A multiple group structural equation modeling procedure was employed in order to test the hypothesis that family environment mediates the relationship between gender and mental health problems, as well as to test for potential differences in these relationships as a function of race/ethnicity. Results indicated support for the mediation model in the sample of African American youth but not in the sample of Caucasian youth.
Mental health problems in college freshmen: Prevalence and academic functioning.
Bruffaerts, Ronny; Mortier, Philippe; Kiekens, Glenn; Auerbach, Randy P; Cuijpers, Pim; Demyttenaere, Koen; Green, Jennifer G; Nock, Matthew K; Kessler, Ronald C
2018-01-01
Mental health problems in college and their associations with academic performance are not well understood. The main aim of this study was to investigate to what extent mental health problems are associated with academic functioning. As part of the World Mental Health Surveys International College Student project, 12-month mental health problems among freshmen (N = 4921) was assessed in an e-survey of students at KU Leuven University in Leuven, Belgium. The associations of mental health problems with academic functioning (expressed in terms of academic year percentage [or AYP] and grade point average [GPA]) were examined across academic departments. Approximately one in three freshman reports mental health problems in the past year, with internalizing and externalizing problems both associated with reduced academic functioning (2.9-4.7% AYP reduction, corresponding to 0.2-0.3 GPA reduction). The association of externalizing problems with individual-level academic functioning was significantly higher in academic departments with comparatively low average academic functioning. Limited sample size precluded further investigation of interactions between department-level and student-level variables. No information was available on freshman secondary school academic performance. Mental health problems are common in college freshman, and clearly associated with lower academic functioning. Additional research is needed to examine the potentially causal nature of this association, and, if so, whether interventions aimed at treating mental health problems might improve academic performance. Copyright © 2017 Elsevier B.V. All rights reserved.
Psychological Abuse, Mental Health, and Acceptance of Dating Violence Among Adolescents.
Temple, Jeff R; Choi, Hye Jeong; Elmquist, JoAnna; Hecht, Michael; Miller-Day, Michelle; Stuart, Gregory L; Brem, Meagan; Wolford-Clevenger, Caitlin
2016-08-01
Existing literature indicates that acceptance of dating violence is a significant and robust risk factor for psychological dating abuse perpetration. Past work also indicates a significant relationship between psychological dating abuse perpetration and poor mental health. However, no known research has examined the relationship between acceptance of dating violence, perpetration of dating abuse, and mental health. In addition to exploring this complex relationship, the present study examines whether psychological abuse perpetration mediates the relationship between acceptance of dating violence and mental health (i.e., internalizing symptoms of depression, anxiety, and hostility). Three waves of longitudinal data were obtained from 1,042 ethnically diverse high school students in Texas. Participants completed assessments of psychological dating abuse perpetration, acceptance of dating violence, and internalizing symptoms (hostility and symptoms of anxiety and depression). As predicted, results indicated that perpetration of psychological abuse was significantly associated with acceptance of dating violence and all internalizing symptoms. Furthermore, psychological abuse mediated the relationship between acceptance of dating violence and internalizing symptoms. Findings from the present study suggest that acceptance of dating violence is an important target for the prevention of dating violence and related emotional distress. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Mojtabai, Ramin; Stuart, Elizabeth A; Hwang, Irving; Eaton, William W; Sampson, Nancy; Kessler, Ronald C
2017-10-01
Epidemiological research has consistently shown an association between mental disorders and marital dissolution. However, this research mostly examined the association of divorce as a risk factor for mental illness. This study prospectively examined the associations of mood, anxiety, and substance use disorders with future marital dissolution and new marriages in a representative population sample. The study used data from the National Comorbidity Survey panel study-a two-wave community epidemiological survey of 5001 participants interviewed in 1990-1992 and re-interviewed in 2001-2003. Mental disorders were ascertained with the Composite International Diagnostic Interview, a fully structured instrument. Associations of baseline lifetime disorders and disorders with onset after the baseline with subsequent divorce and marriage/remarriage were examined using discrete-time survival analysis models. Mental disorders at baseline or with onset after baseline were associated with significantly greater odds of subsequent divorce among respondents who either were married at baseline or got married after baseline. Mental disorders with onset after baseline were associated with smaller odds of marriage or remarriage. Projections assuming causal effects of mental illness on marital outcomes suggest that preventing the effects of common mood, anxiety, and substance use disorders would be associated with 6.7 million fewer divorces and 3.5 million more marriages in the US population over an 11-year period. Individuals with common mental disorders are at greater risk of marital dissolution and are less likely to enter new marriages. These factors contribute to the diminished social engagement and social support for individuals with these disorders. Interventions aimed at improving marital and family relationships could potentially ameliorate the effect of mental disorders on these vital social ties.
Dey, Michelle; Wang, Jen; Jorm, Anthony Francis; Mohler-Kuo, Meichun
2015-03-01
To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition. Parental reports about their 9- to 14-year-old children with mental (n = 785) or physical health problems (n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland. Mental health problems were perceived as being more severe (p < 0.001) and exerting a larger impact upon the family (e.g., financial impact) than physical health problems. Furthermore, fewer parents of children with a mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p = 0.004) and were satisfied with the health care services their child received (p < 0.001). The odds of low health literacy was higher among parents with children suffering from mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p < 0.001); this finding held generally for mental health problem (although only a trend was observable for internalizing problems). The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy.
Hofer, Patrizia D; Wahl, Karina; Meyer, Andrea H; Miché, Marcel; Beesdo-Baum, Katja; Wong, Shiu F; Grisham, Jessica R; Wittchen, Hans-Ulrich; Lieb, Roselind
2018-04-01
Comorbidity of obsessive-compulsive disorder (OCD) with other mental disorders has been demonstrated repeatedly. Few longitudinal studies, however, have evaluated the temporal association of prior OCD and subsequent mental disorders across the age period of highest risk for first onset of mental disorders. We examined associations between prior OCD and a broad range of subsequent mental disorders and simulated proportions of new onsets of mental disorders that could potentially be attributed to prior OCD, assuming a causal relationship. Data from 3,021 14- to 24-year-old community subjects were prospectively collected for up to 10 years. DSM-IV OCD and other DSM-IV mental disorders were assessed with the Munich-Composite International Diagnostic Interview. We used adjusted time-dependent proportional hazard models to estimate the temporal associations of prior OCD with subsequent mental disorders. Prior OCD was associated with an increased risk of bipolar disorders (BIP; [hazard ratio, HR = 6.9, 95% confidence interval, CI, (2.8,17.3)], bulimia nervosa [HR = 6.8 (1.3,36.6)], dysthymia [HR = 4.4 (2.1,9.0)], generalized anxiety disorder (GAD; [HR = 3.4 (1.1,10.9)], and social phobia [HR = 2.9 (1.1,7.7)]). Of these outcome disorders, between 65 and 85% could be attributed to OCD in the exposed group, whereas between 1.5 and 7.7% could be attributed to OCD in the total sample. This study provides strong evidence that prior OCD is associated with an increased risk of subsequent onset of BIP, bulimia nervosa, dysthymia, GAD, and social phobia among adolescents and young adults. Future studies should evaluate if early treatment of OCD can prevent the onset of these subsequent mental disorders. © 2018 Wiley Periodicals, Inc.
Laterality effects in motor learning by mental practice in right-handers.
Gentili, R J; Papaxanthis, C
2015-06-25
Converging evidences suggest that mental movement simulation and actual movement production share similar neurocognitive and learning processes. Although a large body of data is available in the literature regarding mental states involving the dominant arm, examinations for the nondominant arm are sparse. Does mental training, through motor-imagery practice, with the dominant arm or the nondominant arm is equally efficient for motor learning? In the current study, we investigated laterality effects in motor learning by motor-imagery practice. Four groups of right-hander adults mentally and physically performed as fast and accurately as possible (speed/accuracy trade-off paradigm) successive reaching movements with their dominant or nondominant arm (physical-training-dominant-arm, mental-training-dominant-arm, physical-training-nondominant-arm, and mental-training-nondominant-arm groups). Movement time was recorded and analyzed before, during, and after the training sessions. We found that physical and mental practice had a positive effect on the motor performance (i.e., decrease in movement time) of both arms through similar learning process (i.e., similar exponential learning curves). However, movement time reduction in the posttest session was significantly higher after physical practice than motor-imagery practice for both arms. More importantly, motor-imagery practice with the dominant arm resulted in larger and more robust improvements in movement speed compared to motor-imagery practice with the nondominant arm. No such improvements were observed in the control group. Our results suggest a superiority of the dominant arm in motor learning by mental practice. We discussed these findings from the perspective of the internal models theory. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.
Mojtabai, Ramin; Stuart, Elizabeth A.; Hwang, Irving; Eaton, William W.; Sampson, Nancy; Kessler, Ronald C.
2018-01-01
Purpose Epidemiological research has consistently shown an association between mental disorders and marital dissolution. However, this research mostly examined the association of divorce as a risk factor for mental illness. This study prospectively examined the associations of mood, anxiety, and substance use disorders with future marital dissolution and new marriages in a representative population sample. Methods The study used data from the National Comorbidity Survey panel study—a two-wave community epidemiological survey of 5,001 participants assessed in1990–1992 and re-interviewed in 2001–2003. Mental disorders were ascertained with the Composite International Diagnostic Interview, a fully-structured interview. Association of baseline lifetime disorders and disorders with onset after the baseline with subsequent divorce and marriage/remarriage were examined using discrete-time survival analysis models. Results Mental disorders at baseline or with onset after baseline were associated with significantly greater odds of subsequent divorce among respondents who either were married at baseline or got married after baseline. Mental disorders with onset after baseline were associated with smaller odds of marriage or remarriage. Projections assuming causal effects of mental illness on marital outcomes suggest that preventing the effects of common mood, anxiety and substance use disorders would be associated with 6.7 million fewer divorces and 3.5 million more marriages in the US population over an 11 year period. Conclusions Individuals with common mental illnesses are at greater risk of marital dissolution, and are less likely to enter new marriages. These factors contribute to the diminished social engagement and social support for individuals with these disorders. Interventions aimed at improving marital and family relationships could potentially ameliorate the effect of mental disorders on these vital social ties. PMID:28378065
Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy
2011-12-01
The mental health liaison nurse role in the emergency department (ED) has demonstrated a range of positive outcomes for both consumers and staff. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based on this model is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. In evaluating this new service, semistructured interviews were conducted with a random selection of study participants and a stratified sample of ED staff. This is the first of a two-part paper that presents an analysis of qualitative data from interviews conducted with study participants (n = 23). Participants reported numerous therapeutic benefits from the service, such as support, understanding, and a focus on solutions rather than problems, and high levels of satisfaction with the accessibility of the service and follow up. Suggestions for improving the service were also offered. Participants emphasized that overall ED service provision would be enhanced through additional resources, especially an extension of operating hours. Findings from these participant interviews provide strong support for an ED-based MHNP outpatient service. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Alisic, Eva; Groot, Arend; Snetselaar, Hanneke; Stroeken, Tielke; van de Putte, Elise
2015-07-29
The loss of a parent due to intimate partner homicide has a major impact on children. Professionals involved have to make far-reaching decisions regarding placement, guardianship, mental health care and contact with the perpetrating parent, without an evidence base to guide these decisions. We introduce a study protocol to a) systematically describe the demographics, circumstances, mental health and wellbeing of children bereaved by intimate partner homicide and b) build a predictive model of factors associated with children's mental health and wellbeing after intimate partner homicide. This study focuses on children bereaved by parental intimate partner homicide in the Netherlands over a period of 20 years (1993 - 2012). It involves an incidence study to identify all Dutch intimate partner homicide cases between 1993 and 2012 by which children have been bereaved; systematic case reviews to describe the demographics, circumstances and care trajectories of these children; and a mixed-methods study to assess mental health, wellbeing, and experiences regarding decisions made and care provided. Clinical experience and initial research suggest that the children involved often need long-term intensive mental health and case management. The costs of these services are extensive and the stakes are high. This study lays the foundation for an international dataset and evidence-informed decision making.
Benchmarking of HEU Mental Annuli Critical Assemblies with Internally Reflected Graphite Cylinder
DOE Office of Scientific and Technical Information (OSTI.GOV)
Xiaobo, Liu; Bess, John D.; Marshall, Margaret A.
Three experimental configurations of critical assemblies, performed in 1963 at the Oak Ridge Critical Experiment Facility, which are assembled using three different diameter HEU annuli (15-9 inches, 15-7 inches and 13-7 inches) metal annuli with internally reflected graphite cylinder are evaluated and benchmarked. The experimental uncertainties which are 0.00055, 0.00055 and 0.00055 respectively, and biases to the detailed benchmark models which are -0.00179, -0.00189 and -0.00114 respectively, were determined, and the experimental benchmark keff results were obtained for both detailed and simplified model. The calculation results for both detailed and simplified models using MCNP6-1.0 and ENDF VII.1 agree well tomore » the benchmark experimental results with a difference of less than 0.2%. These are acceptable benchmark experiments for inclusion in the ICSBEP Handbook.« less
Toms, Jonathan
2012-12-01
The Foucauldian sociologist Nikolas Rose has influentially argued that psychosocial technologies have offered means through which the ideals of democracy can be made congruent with the management of social life and the government of citizens in modern Western liberal democracies. This interpretation is contested here through an examination of the 1948 International Congress on Mental Health held in London and the mental hygiene movement that organised it. It is argued that, in Britain, this movement's theory and practice represents an uneasy and ambiguous attempt to reconcile visions of 'the modern' with 'the traditional'. The mental hygienist emphasis on the family is central. Here it appears as a forcing-house of the modern self-sustaining individual. Mental hygienists cast the social organisation of 'traditional' communities as static, with rigid authority frustrating both social progress and the full emergence of individual personality. Yet mental hygienists were also concerned about threats to social cohesion and secure personhood under modernity. If the social organisation of 'traditional' communities was patterned by the archetype of the family, with its personal relations of authority, mental hygienists compressed these relations into the 'private' family. Situated here they became part of a developmental process of mental adjustment through which 'mature', responsible citizens emerged. This reformulation of the family's centrality for the social order informed mental hygienist critiques of the growth of state power under existing forms of democracy, as well as suspicion of popular political participation or protest, and of movements towards greater egalitarianism.
Hawkins, Amy L; Haskett, Mary E
2014-01-01
Abused children's internal working models (IWM) of relationships are known to relate to their socioemotional adjustment, but mechanisms through which negative representations increase vulnerability to maladjustment have not been explored. We sought to expand the understanding of individual differences in IWM of abused children and investigate the mediating role of self-regulation in links between IWM and adjustment. Cluster analysis was used to subgroup 74 physically abused children based on their IWM. Internal working models were identified by children's representations, as measured by a narrative story stem task. Self-regulation was assessed by teacher report and a behavioral task, and adjustment was measured by teacher report. Cluster analyses indicated two subgroups of abused children with distinct patterns of IWMs. Cluster membership predicted internalizing and externalizing problems. Associations between cluster membership and adjustment were mediated by children's regulation, as measured by teacher reports of many aspects of regulation. There was no support for mediation when regulation was measured by a behavioral task that tapped more narrow facets of regulation. Abused children exhibit clinically relevant individual differences in their IWMs; these models are linked to adjustment in the school setting, possibly through children's self-regulation. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
Dunt, David R; Benoy, Andrew W; Phillipou, Andrea; Collister, Laura L; Crowther, Elizabeth M; Freidin, Julian; Castle, David J
2017-10-01
Objective The Doorway program is a 3-year pilot integrated housing and recovery support program aimed at people with a severe and persistent mental illness who are 'at risk' or actually homeless. Participants source and choose properties through the open rental market, with appropriate rental subsidy and brokerage support. This arrangement is highly innovative, differing from widely favoured arrangements internationally involving congregate and scattered-site housing owned or managed by the support program. The aim of the present study was to determine the effects of the Doorway program on participants' health, housing, service utilisation and costs. Methods A pre-post study design was used with outcome measures consisting of a number of question inventories and their costs (where relevant). The principal inventories were the Behaviour and Symptom Identification Scale 32 (BASIS-32), a consumer-oriented, self-report measure of behavioural symptoms and distress, the Health of the Nation Outcome Scale (HoNOS), an interviewer-administered measurement tool designed to assess general health and social functioning of mentally ill people and the Outcomes Star (Homelessness) system which measures various aspects of the homelessness experience. Baseline measurements were performed routinely by staff at entry to the program and then at 6-monthly intervals across the evaluation period. Results For 55 of 59 participants, total mean BASIS-32 scores (including as well three of five subscale scores) improved significantly and with moderate effect size. Four of the 10 domain scores on the Outcome Star (Homelessness) inventory also improved significantly, with effect sizes ranging from small-medium (three domains) to large (one domain). Mean usage of bed-based mental health clinical services and general hospital admissions both significantly decreased (with overall net savings of A$3096 per participant per annum). Overall cost savings (including housing) to government ranged from A$1149 to A$19837 depending on the housing type comparator. Conclusion The Doorway program secured housing for this vulnerable group with additional benefits in client outcomes, including reduced use and cost of health services. These findings, if confirmed in larger studies, should have widespread applicability internationally. What is known about the topic? Beneficial effects of housing and recovery programs (Housing First) on people with severe and persistent mental illness and who are 'at risk', or actually homeless, are being demonstrated in Northern America. These effects include housing security, well being, health service utilisation and cost effects on government. However, these beneficial effects can only be regarded as settled for housing security. The highly innovative Doorway care model in which participants source and choose properties through the open rental market, with appropriate rental subsidy and brokerage support, has not been investigated previously. What does this paper add? This paper adds new data on the Doorway care models, it's effects and costs, particularly with regard to participant behavioural distress and social functioning. What are the implications for practitioners? The beneficial effects of this innovative model, if confirmed in larger studies, should have widespread applicability internationally.
Mental illness stigma in the Israeli context: deliberations and suggestions.
Tal, Amir; Roe, David; Corrigan, Patrick W
2007-11-01
In this paper we deliberate mental illness stigma in the Israeli context and suggest ways to reduce it, emphasizing the community's role in the rehabilitation of persons with mental illness. A literature review of Israeli and international literature of mental illness stigma. Community mental health, in addition to its traditional focus on developing community-based services, should focus also on community-based interventions such as the delivery of anti-stigma interventions. Providing individualized rehabilitation services in the community while addressing stigma-induced social barriers may create a better recovery ground for Israelis with mental illness.
Matejkowski, Jason; McCarthy, Kevin S; Draine, Jeffrey
2011-01-01
A measure of an individual's level of internalization of the norm of reciprocity may signal exchange preferences and indicate whether "active" or "passive" mental health services are preferable to consumers. We evaluated the psychometric properties of one such measure, the Personal Norm of Reciprocity (PNR) scale. We recruited 70 persons receiving mental health services and 65 comparison participants to complete questionnaires assessing reciprocity tendencies and correlates of mental illness. Two of three subscales of a shortened PNR showed evidence of reliability and validity. Consumers endorsed higher levels of the reciprocity norm than persons not seeking services. Persons in "active" service settings displayed greater rigidity in application of the reciprocity norm than individuals in "passive" service settings or comparison participants. The shortened PNR can be a useful measure of individual reciprocity preferences. Measurement of the internalization of the norm of reciprocity may assist practitioners in identifying what types of services are more likely to retain and benefit mental health service consumers.
Sexual orientation, internal migration, and mental health during the transition to adulthood.
Ueno, Koji; Vaghela, Preeti; Ritter, Lacey J
2014-12-01
Previous research has suggested that sexual minorities may have higher rates of migration than heterosexuals, indicating their effort to escape stigma in the currently residing areas. However, direct evidence for the migration pattern has been lacking, and mental health implications of such coping effort have been unclear. This study seeks to fill these gaps in the literature by analyzing the Add Health data, which include longitudinal measures of residential locations, sexual orientation, and mental health. The analysis focuses on the transition to adulthood, when the rate of internal migration peaks. Among women, sexual minorities have a higher rate of migration than heterosexuals, but men do not show such a difference. Sexual minorities show better mental health when they migrate to counties with higher proportions of people living in urban areas whereas heterosexuals do not show such an association. Among sexual minority men, migration to counties with higher population density and higher proportions of college-educated residents is also linked to better mental health. © American Sociological Association 2014.
Parental Use of Corporal Punishment in Europe: Intersection between Public Health and Policy
duRivage, Nathalie; Keyes, Katherine; Leray, Emmanuelle; Pez, Ondine; Bitfoi, Adina; Koç, Ceren; Goelitz, Dietmar; Kuijpers, Rowella; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Fermanian, Christophe; Kovess-Masfety, Viviane
2015-01-01
Studies have linked the use of corporal punishment of children to the development of mental health disorders. Despite the recommendation of international governing bodies for a complete ban of the practice, there is little European data available on the effects of corporal punishment on mental health and the influence of laws banning corporal punishment. Using data from the School Children Mental Health Europe survey, the objective of this cross-sectional study was to examine the prevalence and legal status of corporal punishment across six European countries and to evaluate the association between parental use of corporal punishment and children’s mental health. The study found that odds of having parents who reported using occasional to frequent corporal punishment were 1.7 times higher in countries where its use is legal, controlling for socio-demographic factors. Children with parents who reported using corporal punishment had higher rates of both externalized and internalized mental health disorders. PMID:25674788
An investigation of the mentalization-based model of borderline pathology in adolescents.
Quek, Jeremy; Bennett, Clair; Melvin, Glenn A; Saeedi, Naysun; Gordon, Michael S; Newman, Louise K
2018-07-01
According to mentalization-based theory, transgenerational transmission of mentalization from caregiver to offspring is implicated in the pathogenesis of borderline personality disorder (BPD). Recent research has demonstrated an association between hypermentalizing (excessive, inaccurate mental state reasoning) and BPD, indicating the particular relevance of this form of mentalizing dysfunction to the transgenerational mentalization-based model. As yet, no study has empirically assessed a transgenerational mentalization-based model of BPD. The current study sought firstly to test the mentalization-based model, and additionally, to determine the form of mentalizing dysfunction in caregivers (e.g., hypo- or hypermentalizing) most relevant to a hypermentalizing model of BPD. Participants were a mixed sample of adolescents with BPD and a sample of non-clinical adolescents, and their respective primary caregivers (n = 102; 51 dyads). Using an ecologically valid measure of mentalization, mediational analyses were conducted to examine the relationships between caregiver mentalizing, adolescent mentalizing, and adolescent borderline features. Findings demonstrated that adolescent mentalization mediated the effect of caregiver mentalization on adolescent borderline personality pathology. Furthermore, results indicated that hypomentalizing in caregivers was related to adolescent borderline personality pathology via an effect on adolescent hypermentalizing. Results provide empirical support for the mentalization-based model of BPD, and suggest the indirect influence of caregiver mentalization on adolescent borderline psychopathology. Results further indicate the relevance of caregiver hypomentalizing to a hypermentalizing model of BPD. Copyright © 2018 Elsevier Inc. All rights reserved.
Feder, Kenneth A; Heatherington, Laurie; Mojtabai, Ramin; Eaton, William W
2018-06-26
Social support in marriage may be associated with reduced risk for mental illness. Past studies are limited by short follow up and a focus on depression. A two-wave nationally representative survey in the United States (n = 2,503) is used to examine whether social support in marriage is associated with the onset of each of four clusters of disorders-internalizing, externalizing, phobic, and bipolar-10 years later. Results indicate that higher levels of perceived marital support were protective against internalizing, fear, and bipolar disorders, and against incident externalizing disorders for women. Protective effects of social support in marriage against mental illness are long-lasting, and sometimes differ by gender. Findings suggest the importance of mental health assessment in clinical practice. © 2018 American Association for Marriage and Family Therapy.
The light of SESAME: A dream becomes reality
NASA Astrophysics Data System (ADS)
Schopper, H.
2017-04-01
The foundation of the international SESAME synchrotron laboratory in Jordan is described including political, technical, scientific and financial aspects. Following the model of CERN, its objective is not only to promote science but also bring people together from countries with different traditions, religions and mentalities. To create an international organisation in the Middle East and North Africa (MENA) region required sometimes quite unconventional procedures not disclosed in any official document. Because of the exceptional circumstances, a more detailed description of its history may be of interest. Although its success was doubted by many at its start, the facility will start operation in spring 2017.
Crossingham, Jodi L; Jenkinson, Jodie; Woolridge, Nick; Gallinger, Steven; Tait, Gordon A; Moulton, Carol-Anne E
2009-01-01
Background: Given the increasing number of indications for liver surgery and the growing complexity of operations, many trainees in surgical, imaging and related subspecialties require a good working knowledge of the complex intrahepatic anatomy. Computed tomography (CT), the most commonly used liver imaging modality, enhances our understanding of liver anatomy, but comprises a two-dimensional (2D) representation of a complex 3D organ. It is challenging for trainees to acquire the necessary skills for converting these 2D images into 3D mental reconstructions because learning opportunities are limited and internal hepatic anatomy is complicated, asymmetrical and variable. We have created a website that uses interactive 3D models of the liver to assist trainees in understanding the complex spatial anatomy of the liver and to help them create a 3D mental interpretation of this anatomy when viewing CT scans. Methods: Computed tomography scans were imported into DICOM imaging software (OsiriX™) to obtain 3D surface renderings of the liver and its internal structures. Using these 3D renderings as a reference, 3D models of the liver surface and the intrahepatic structures, portal veins, hepatic veins, hepatic arteries and the biliary system were created using 3D modelling software (Cinema 4D™). Results: Using current best practices for creating multimedia tools, a unique, freely available, online learning resource has been developed, entitled Visual Interactive Resource for Teaching, Understanding And Learning Liver Anatomy (VIRTUAL Liver) (http://pie.med.utoronto.ca/VLiver). This website uses interactive 3D models to provide trainees with a constructive resource for learning common liver anatomy and liver segmentation, and facilitates the development of the skills required to mentally reconstruct a 3D version of this anatomy from 2D CT scans. Discussion: Although the intended audience for VIRTUAL Liver consists of residents in various medical and surgical specialties, the website will also be useful for other health care professionals (i.e. radiologists, nurses, hepatologists, radiation oncologists, family doctors) and educators because it provides a comprehensive resource for teaching liver anatomy. PMID:19816618
Effects of daily noise on fetuses and cerebral hemisphere specialization in children
NASA Astrophysics Data System (ADS)
Ando, Y.
1988-12-01
This paper first provides an overview of work by the author and colleagues on effects of noise on fetuses demonstrating growth inhibition. As a second issue, the effects of daily noise on the mental abilities of children are discussed in relation to task specification of cerebral hemispheres. Two different types of mental tasks were given to a total of 1286 children (7-10 years old) who live in a noisy area around an international airport or in a neighbouring quiet area, under conditions of no sound, jet-plane noise stimulus and music stimulus. In the quiet neighborhood, results may support a model that noise and calculation tasks are separately processed in the right and left cerebral hemisphere, respectively. Music perception and calculation are considered to be processed one after the other in the left hemisphere. In the pattern search task used as the right hemispheric task, no significant differences appeared under either stimulus sound, with the exception of a slight interference observed in the noise group. In the noisy living area, however, effects of temporary sound on mental tasks appeared to be quite different from the first-mentioned results. These facts suggest that daily noise affects the development of cerebral specialization of growing children. As little is known about effects of noise on growing children, it is recommended that international cooperation be initiated to establish the need for and conditions of healthy sound environments.
Oscillatory networks of high-level mental alignment: A perspective-taking MEG study.
Seymour, R A; Wang, H; Rippon, G; Kessler, K
2018-08-15
Mentally imagining another's perspective is a high-level social process, reliant on manipulating internal representations of the self in an embodied manner. Recently Wang et al. (2016) showed that theta-band (3-7 Hz) brain oscillations within the right temporo-parietal junction (rTPJ) and brain regions coding for motor/body schema contribute to the process of perspective-taking. Using a similar paradigm, we set out to unravel the extended functional brain network in detail. Increasing the angle between self and other perspective was accompanied by longer reaction times and increases in theta power within rTPJ, right lateral prefrontal cortex (PFC) and right anterior cingulate cortex (ACC). Using Granger-causality, we showed that lateral PFC and ACC exert top-down influence over rTPJ, indicative of executive control processes required for managing conflicts between self and other perspectives. Finally, we quantified patterns of whole-brain phase coupling in relation to the rTPJ. Results suggest that rTPJ increases its theta-band phase synchrony with brain regions involved in mentalizing and regions coding for motor/body schema; whilst decreasing synchrony to visual regions. Implications for neurocognitive models are discussed, and it is proposed that rTPJ acts as a 'hub' to route bottom-up visual information to internal representations of the self during perspective-taking, co-ordinated by theta-band oscillations. Copyright © 2018 Elsevier Inc. All rights reserved.
European military mental health research: benefits of collaboration.
Himmerich, Hubertus; Willmund, G D; Wesemann, U; Jones, N; Fear, N T
2017-06-01
Despite joint participation in international military operations, few collaborative military mental health research projects have been undertaken by European countries. From a common perspective of military mental health researchers from Germany and the UK, the lack of shared research might be related not only to the use of different languages but also the different ways in which the two militaries provide mental health and medical support to operations and differences in military institutions. One area that is suitable for military health research collaboration within UK and German forces is mental health and well-being among military personnel. This could include the study of resilience factors, the prevention of mental disorder, mental health awareness, stigma reduction and the treatment of mental disorder. Military mental health research topics, interests and the studies that have been conducted to date in the UK and Germany have considerable overlap and commonality of purpose. To undertake the investigation of the long-term consequences of operational deployment, the specific burdens placed on military families and to further the understanding of the role of factors such as biomarkers for use in military mental health research, it seems advisable to forge international research alliances across European nations, which would allow for researchers to draw transcultural and generalisable conclusions from their work. Such an enterprise is probably worthwhile given the shared research interests of Germany and the UK and the common perspectives on military mental health in particular. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Campos, Ricardo; Novella, Enric
In this paper, we study the ideological bases of mental hygiene, understood as racial and moral hygiene, during the first years of Franco's regime and their evolution until 1960. First, we discuss the conceptualization of mental hygiene in the 1940s and its role as a tool for the legitimization of dictatorship, revealing the involvement of orthodox Catholicism and its links with moral and racial hygiene. Second, we assess the transformation of mental hygiene during the 1950s towards modernization and a stronger linkage with the dominant trends of contemporary psychiatry without ever leaving the ideological background of Catholicism. For this purpose, we will focus on analysis of the activities of the Mental Hygiene Week held in Barcelona in 1954 and on the creation in 1955 of the National Board of Psychiatric Care, which took on mental hygiene as one of its functions. This paper shows the close relationship of mental hygiene during the early years of Francoism with the political principles of the Dictatorship. The 1940s witnessed the deployment of a harsh discourse in which mental hygiene was a tool for the (moral and spiritual) education of the Spanish people in the political principles of the "New State", pathologizing political dissent and ideologically purifying the country. In the 1950s, Francoist mental hygiene underwent a process of aggiornamento marked by international political events following the defeat of fascism in World War II, advancing a project for (authoritarian) modernization in an international context already directed towards mental health.
Roustit, Christelle; Campoy, Eric; Chaix, Basile; Chauvin, Pierre
2010-07-01
Parental psychopathology is associated with increased psychosocial maladjustment in adolescents. We examined, from a psychosocial perspective, the association between parental psychological distress and psychosocial maladjustment in adolescents and assessed the mediating role of psychosocial covariates. This is a cross-sectional survey and the setting include representative sample of Quebec adolescents in 1999. The participants of the study include 13- and 16-year-old children (N = 2,346) in the Social and Health Survey of Quebec Children and Adolescents. The main outcome measures are internalizing disorders, externalizing disorders, substance use, and alcohol consumption. For statistical analysis, we used structural equation modeling to test for mediation. Internalizing and externalizing disorders were significantly associated with parental psychological distress, but not substance use or alcohol consumption. The higher the parental distress, the higher the risk of adolescent mental health disorders. The association between parental psychological distress and internalizing disorders was mediated by adolescent self-esteem, parental emotional support and extrafamilial social support. As for externalizing disorders, these variables only had an independent effect. In conclusion, A family's well being is a necessary condition for psychosocial adjustment in adolescence. Beyond the psychiatric approach, psychosocial considerations need to be taken into consideration to prevent negative mental health outcomes in children living in homes with distressed parents.
Campoy, Eric; Chaix, Basile; Chauvin, Pierre
2010-01-01
Abstract Parental psychopathology is associated with increased psychosocial maladjustment in adolescents. We examined, from a psychosocial perspective, the association between parental psychological distress and psychosocial maladjustment in adolescents and assessed the mediating role of psychosocial covariates. This is a cross-sectional survey and the setting include representative sample of Quebec adolescents in 1999. The participants of the study include 13- and 16-year-old children (N = 2,346) in the Social and Health Survey of Quebec Children and Adolescents. The main outcome measures are internalizing disorders, externalizing disorders, substance use, and alcohol consumption. For statistical analysis, we used structural equation modeling to test for mediation. Internalizing and externalizing disorders were significantly associated with parental psychological distress, but not substance use or alcohol consumption. The higher the parental distress, the higher the risk of adolescent mental health disorders. The association between parental psychological distress and internalizing disorders was mediated by adolescent self-esteem, parental emotional support and extrafamilial social support. As for externalizing disorders, these variables only had an independent effect. In conclusion, A family’s well being is a necessary condition for psychosocial adjustment in adolescence. Beyond the psychiatric approach, psychosocial considerations need to be taken into consideration to prevent negative mental health outcomes in children living in homes with distressed parents. PMID:20127380
Gudiño, Omar G; Stiles, Allison A; Diaz, Kathleen I
2018-06-01
Despite high rates of exposure to community violence among Latino youth in urban communities, there is considerable variability in individual outcomes. This study examined (a) associations between coping and indices of Latino culture, (b) main effects of active/avoidant coping on psychopathology, and (c) whether coping moderates the impact of violence exposure on mental health in Latino youth. Participants included 168 Latino youth (56% female; ages 11-14) that took part in a short-term longitudinal study. Results indicate that youth acculturation was positively associated with active coping, but enculturation level and immigrant status were not associated with coping. Structural equation models suggested that active coping was negatively associated with internalizing problems (p = .046) while avoidant coping was positively associated with internalizing problems (p = .013) and posttraumatic stress symptoms (p = .024). Moderation analyses revealed that violence exposure was more strongly associated with internalizing problems as reliance on avoidance coping increased. However, at high levels of violence exposure, a greater reliance on active coping was related to increased posttraumatic stress problems. Findings suggest that consideration of the specific stressor, level of stress exposure, and mental health problem-type may be crucial in determining the effectiveness of a coping strategy. Implications for future research and intervention are discussed.
Diagnosing Students' Mental Models via the Web-Based Mental Models Diagnosis System
ERIC Educational Resources Information Center
Wang, Tzu-Hua; Chiu, Mei-Hung; Lin, Jing-Wen; Chou, Chin-Cheng
2013-01-01
Mental models play an important role in science education research. To extend the effectiveness of conceptual change research and to improve mental model identi?cation and diagnosis, the authors developed and tested the Web-Based Mental Models Diagnosis (WMMD) system. In this article, they describe their WMMD system, which goes beyond the…
The professionalization of psychology within the apartheid state 1948-1978.
Laurenson, Helen; Swartz, Sally
2011-08-01
When the National Party came to power in South Africa in 1948 it inherited an ageing colonial psychiatric system underpinned by British-based mental health legislation promulgated in 1916. This situation remained substantially unchanged until the late 1960s, despite the apartheid government's far-reaching attempts to restructure other aspects of the social landscape. The 1966 assassination of South Africa's prime minister by a schizophrenic parliamentary messenger led directly to a series of commissions of enquiry into the management of mental health services, followed by new mental health legislation in 1973 and the compulsory registration of clinical psychologists. The increasing professionalization of psychology, and the apartheid state's policy in relation to the profession, are considered in the light of local and international influences. Unlike the Nazi and Soviet governments, the apartheid state did not seek to create a new psychology and psychiatry in its own image but was instead motivated by a desire to emulate Western models and to identify and control the dangerous individual.
A Healthy Start: Promoting Mental Health and Well-Being in the Early Primary School Years
ERIC Educational Resources Information Center
Cefai, Carmel; Camilleri, Liberato
2015-01-01
Mental health problems in children represent a significant international health concern, with up to one in five children using mental health services during the course of any given year. Identifying the processes of what prevents social, emotional and behaviour difficulties (SEBD) and promotes healthy development from an early age can make a…
ERIC Educational Resources Information Center
Taggart, L.; McMillan, R.; Lawson, A.
2010-01-01
Aim: There is a growing evidence of the physical and mental health inequalities in people with intellectual disability (ID) although less has been written concerning the mental health of women with ID (International Association for the Scientific Study of Intellectual Disabilities). This is compared with the substantive literature published within…
Drazdowski, Tess K; Perrin, Paul B; Trujillo, Michael; Sutter, Megan; Benotsch, Eric G; Snipes, Daniel J
2016-02-01
Experiences with lesbian, gay, bisexual, transgender, or queer (LGBTQ) discrimination and racism have both been associated with mental health problems and illicit drug use. However, the cumulative effects of both forms of discrimination--and resulting internalized oppression--on illicit drug use in LGBTQ people of color (POC) has not been examined in the research literature. Using online questionnaires, this study collected self-report data from 200 LGBTQ POC about their experiences with racism, LGBTQ discrimination, internalized racism, internalized LGBTQ discrimination, and illicit drug use. Two structural equation models yielded adequate fit indices in which experiences with racism and LGBTQ discrimination led to more internalized oppression, which then led to greater illicit drug use magnitude. LGBTQ discrimination was directly related to increased internalized oppression, which was positively associated with illicit drug use magnitude; the relationship between LGBTQ discrimination and illicit drug use magnitude was mediated by internalized oppression in both models. However, racism and the interaction between racism and LGBTQ discrimination did not show valid direct effects on internalized oppression or indirect effects on illicit drug use magnitude. LGBTQ POC can be the targets of both racism and LGBTQ discrimination, although the current study found that the most psychologically damaging effects may come from LGBTQ discrimination. Interventions meant to decrease or prevent illicit drug use in LGBTQ POC may benefit from helping participants examine the links among LGBTQ discrimination, internalized oppression, and illicit drug use as a coping strategy, focusing on substituting more adaptive coping. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Valdivieso-Mora, Esmeralda; Peet, Casie L.; Garnier-Villarreal, Mauricio; Salazar-Villanea, Monica; Johnson, David K.
2016-01-01
Background: Familismo or familism is a cultural value frequently seen in Hispanic cultures, in which a higher emphasis is placed on the family unit in terms of respect, support, obligation, and reference. Familism has been implicated as a protective factor against mental health problems and may foster the growth and development of children. This study aims at measuring the size of the relationship between familism and mental health outcomes of depression, suicide, substance abuse, internalizing, and externalizing behaviors. Methods: Thirty-nine studies were systematically reviewed to assess the relationship between familism and mental health outcomes. Data from the studies were comprised and organized into five categories: depression, suicide, internalizing symptoms, externalizing symptoms, and substance use. The Cohen's d of each value (dependent variable in comparison to familism) was calculated. Results were weighted based on sample sizes (n) and total effect sizes were then calculated. It was hypothesized that there would be a large effect size in the relationship between familism and depression, suicide, internalizing, and externalizing symptoms and substance use in Hispanics. Results: The meta-analysis showed small effect sizes in the relationship between familism and depression, suicide and internalizing behaviors. And no significant effects for substance abuse and externalizing behaviors. Discussion: The small effects found in this study may be explained by the presence of moderator variables between familism and mental health outcomes (e.g., communication within the family). In addition, variability in the Latino samples and in the measurements used might explain the small and non-significant effects found. PMID:27826269
ERIC Educational Resources Information Center
International League of Societies for the Mentally Handicapped, Brussels (Belgium).
The booklet presents the proceedings (in English, French, Spanish, and German) of Session 62 of the Seventh World Congress of the International League of Societies for the Mentally Handicapped, detailing some analytical guidelines for national societies on the implementation of the rights of mentally retarded persons. Rights discussed include…
Internal and External Imagery Effects on Tennis Skills Among Novices.
Dana, Amir; Gozalzadeh, Elmira
2017-10-01
The purpose of this study was to determine the effects of internal and external visual imagery perspectives on performance accuracy of open and closed tennis skills (i.e., serve, forehand, and backhand) among novices. Thirty-six young male novices, aged 15-18 years, from a summer tennis program participated. Following initial skill acquisition (12 sessions), baseline assessments of imagery ability and imagery perspective preference were used to assign participants to one of three groups: internal imagery ( n = 12), external imagery ( n = 12), or a no-imagery (mental math exercise) control group ( n = 12). The experimental interventions of 15 minutes of mental imagery (internal or external) or mental math exercises followed by 15 minutes of physical practice were held three times a week for six weeks. The performance accuracy of the groups on the serve, forehand, and backhand strokes was measured at pre- and post-test using videotaping. Results showed significant increases in the performance accuracy of all three tennis strokes in all three groups, but serve accuracy in the internal imagery group and forehand accuracy in the external imagery group showed greater improvements, while backhand accuracy was similarly improved in all three groups. These findings highlight differential efficacy of internal and external visual imagery for performance improvement on complex sport skills in early stage motor learning.
Social network, recovery attitudes and internal stigma among those with serious mental illness.
Cullen, Bernadette Am; Mojtabai, Ramin; Bordbar, Elahe; Everett, Anita; Nugent, Katie L; Eaton, William W
2017-08-01
Social network size and strength is an important determinant of overall health. This study describes the extent and strength of the social network among a sample of individuals with serious mental illness (SMI) and explores the relationship between an individual's social network and their experience of internal stigma and recovery attitudes. Over a 2-year period, consecutive new patients with SMI attending two community mental health clinics were recruited and interviewed using a comprehensive battery of assessments including assessment of internalized stigma, recovery attitudes and symptom severity. Among the 271 patients interviewed, social network size was small across all diagnostic categories. In adjusted results, the number of friends and support from relatives and friends was significantly related to the personal confidence and hope recovery attitude ( p < .05). The number of relatives and friends and support from relatives was significantly related to internalized stigma ( p < .05). Frequency of contact with relatives or friends was not related to either recovery factors or internalized stigma. There is a significant positive relationship between the size and perceived strength of an individual's social network and internalized stigma and some recovery attitudes. Clinical programs that address any of these factors could potentially improve outcomes for this population.
Clark, Lee Anna; Cuthbert, Bruce; Lewis-Fernández, Roberto; Narrow, William E; Reed, Geoffrey M
2017-09-01
The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals-the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders-provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health's Research Domain Criteria provides a framework that emphasizes integration of basic behavioral and neuroscience research to deepen the understanding of mental disorder. We identify four key issues that present challenges to understanding and classifying mental disorder: etiology, including the multiple causality of mental disorder; whether the relevant phenomena are discrete categories or dimensions; thresholds, which set the boundaries between disorder and nondisorder; and comorbidity, the fact that individuals with mental illness often meet diagnostic requirements for multiple conditions. We discuss how the three systems' approaches to these key issues correspond or diverge as a result of their different histories, purposes, and constituencies. Although the systems have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.
Lanza, H. Isabella; Li, Libo; Kahn, Emily; Evans, Elizabeth; Schulte, Marya
2014-01-01
Maternal substance abuse and mental disorders can have adverse impacts on child development. We investigated the impact of maternal mental health on child behaviors based on a long-term follow-up study of mothers and their children approximately 10 years after mothers’ admission to drug abuse treatment. Mothers (n=396) were assessed at admission to drug treatment during 2000 to 2002, and at follow-up in 2010–2011. At follow-up, each mother was asked to assess one target child using the Child Behavior Checklist for ages 6–18 (CBCL). Mothers’ mental disorder diagnoses were obtained from records maintained by the California Department of Mental Health in 2009. About 46% of mothers had comorbid mental disorders; 27% had depressive disorder, 15% bipolar disorder, 15% adjustment disorder, 13% anxiety disorder, and 6% psychotic disorder. Of these mothers, more than half had two or more mental disorder diagnoses. The average age of the target child was approximately 10 years old (range 6 to 17). Relative to children of mothers without comorbid mental disorders, children were more likely to demonstrate internalizing behaviors if their mothers had comorbid depression/anxiety disorders (OR=2.0, 95%CI:1.0–4.0) or severe mental disorders (psychoses, bipolar) (OR=3.4, 95%CI:1.5–7.6). For externalizing behaviors, family problems was the only significant predictor (OR=3.2, 95%CI:1.7–6.0 for children of mothers with depression/anxiety disorders, OR=3.9, 95%CI:1.9–7.8 for severe mental disorders). Addressing maternal mental disorders (particularly severe mental disorders) and family problems are important for child well-being as these factors were significantly related to emotional and problem behaviors of children. PMID:25750503
Palmquist, Lucianne; Patterson, Sue; O'Donovan, Analise; Bradley, Graham
2017-07-20
Policies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental illness, applicability to youth services and relevance to young people is uncertain, particularly as little is known about young people's views. A comprehensive understanding of the experiences and expectations of young people is critical to developing youth mental health services that are acceptable, accessible, effective and relevant. To inform development of policy and youth services, the study described in this protocol aims to develop a comprehensive account of the experiences and expectations of 12-17 year olds as they encounter mental disorders and transition through specialist mental health services. Data will be analysed to model recovery from the adolescents' perspective. This grounded theory study will use quantitative and qualitative data collected in interviews with 12-17 year olds engaged with specialist Child/Youth Mental Health Service in Queensland, Australia. Interviews will explore adolescents' expectations and experiences of mental disorder, and of services, as they transition through specialist mental health services, including the meaning of their experiences and ideas of 'recovery' and how their experiences and expectations are shaped. Data collection and analysis will use grounded theory methods. Adolescents' experiences will be presented as a mid-range theory. The research will provide tangible recommendations for youth-focused mental health policy and practice. Findings will be disseminated within academic literature and beyond to participants, health professionals, mental health advocacy groups and policy and decision makers via publications, research summaries, conferences and workshops targeting different audiences. Ethical and research governance approvals have been obtained from relevant Human Research Ethics committees and all sites involved. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Pearl, Rebecca L; White, Marney A; Grilo, Carlos M
2014-05-01
This study aimed to examine the relationship between internalization of weight bias, which has been linked to specific negative mental health outcomes, and overall mental and physical health among overweight patients with binge eating disorder (BED). The role of depressive symptoms as a potential mediator in this relationship was also tested. In a cross-sectional study, 255 individuals who were overweight and seeking treatment for BED completed the Weight Bias Internalization Scale (WBIS), Short-Form 36 Health Survey (SF-36), and Beck Depression Inventory-II (BDI). Regression analyses were conducted to evaluate the relationship between the WBIS and the SF-36, and bootstrapping mediation analyses were conducted to test whether BDI scores mediated this relationship. Higher weight bias internalization was associated with poorer self-reported health on all scales of the SF-36, and BDI scores mediated the relationship. Additional analyses revealed that WBIS scores also mediated the relationship between BDI scores and three SF-36 scales. Weight bias internalization is associated with poorer overall mental and physical health, and depressive symptoms may play a role in accounting for this relationship in treatment-seeking overweight patients with BED. © 2013 The Obesity Society.
Severe physical punishment: risk of mental health problems for poor urban children in Brazil
Duarte, Cristiane S; Peres, Clovis A; Nascimento, Rosimeire; Curto, Bartira M; Paula, Cristiane S
2009-01-01
Abstract Objective To examine the relationship between specific types of child mental health problems and severe physical punishment, in combination with other important known risk factors. Methods We conducted a cross-sectional study in Embu, São Paulo, Brazil, as the Brazilian component of a multicountry survey on abuse in the family environment. From a probabilistic sample of clusters that included all eligible households (women aged 15–49 years with a son or daughter < 18 years of age), we randomly selected one mother–child pair per household (n = 813; attrition rate: 17.6%). This study focused on children aged 6–17 years (n = 480). Child Behaviour Checklist CBCL/6–18 was used to identify children with internalizing problems only, externalizing problems only, and both internalizing and externalizing problems (comorbidity). Severe physical punishment was defined as being hit with an object, being kicked, choked, smothered, burnt, scalded, branded, beaten or threatened with a weapon. We examined other potential correlates from four domains: child (gender, age, ever witnessing marital violence); mother (education, unemployment, anxiety or depression, marital violence); father (absence, drunkenness); and family (socioeconomic status). The WHO Self-Reporting Questionnaire (SRQ-20) was used to identify maternal anxiety or depression (score > 7). Backward logistic regression analysis identified independent correlates and significant interactions. Findings Multivariate modelling showed that severe punishment was an independent correlate of comorbid internalizing and externalizing problems but was not associated with internalizing problems only. It increased the risk of externalizing problems alone only for children and adolescents not exposed to maternal anxiety or depression. Maternal anxiety or depression increased the risk only for children or adolescents not exposed to severe punishment. Conclusion Severe punishment may be related to child mental health problems, with the mechanism depending on the type of problem. Its influence persists in the presence of family stressors such as the father’s absence and maternal anxiety or depression. PMID:19551251
de Almeida Vieira Monteiro, Ana Paula Teixeira; Fernandes, Alexandre Bastos
2016-05-17
Cultural competence is an essential component in rendering effective and culturally responsive services to culturally and ethnically diverse clients. Still, great difficulty exists in assessing the cultural competence of mental health nurses. There are no Portuguese validated measurement instruments to assess cultural competence in mental health nurses. This paper reports a study testing the reliability and validity of the Portuguese version of the Multicultural Mental Health Awareness Scale-MMHAS in a sample of Portuguese nurses. Following a standard forward/backward translation into Portuguese, the adapted version of MMHAS, along with a sociodemographic questionnaire, were applied to a sample of 306 Portuguese nurses (299 males, 77 females; ages 21-68 years, M = 35.43, SD = 9.85 years). A psychometric research design was used with content and construct validity and reliability. Reliability was assessed using internal consistency and item-total correlations. Construct validity was determined using factor analysis. The factor analysis confirmed that the Portuguese version of MMHAS has a three-factor structure of multicultural competencies (Awareness, Knowledge, and Skills) explaining 59.51% of the total variance. Strong content validity and reliability correlations were demonstrated. The Portuguese version of MMHAS has a strong internal consistency, with a Cronbach's alpha of 0.958 for the total scale. The results supported the construct validity and reliability of the Portuguese version of MMHAS, proving that is a reliable and valid measure of multicultural counselling competencies in mental health nursing. The MMHAS Portuguese version can be used to evaluate the effectiveness of multicultural competency training programs in Portuguese-speaking mental health nurses. The scale can also be a useful in future studies of multicultural competencies in Portuguese-speaking nurses.
2015-07-27
studying an expert physician. In Proceedings of the 8th International Conference on Artificial Intelligence (pp. ###-###). Los Altos, CA: Morgan...incidentally on analogy lo particular past cases (e.g., a fire involving a billboard on a rooftop brought to mind a past case involving a billboard). Rather...Action. Los Angeles, CA: Sage CQ Press. Bums, K. (2005). Mental models and normal errors. In H, Montgomery, R, Lipshitz & B, Brehmer (Eds.), How
Kanehara, Akiko; Kotake, Risa; Miyamoto, Yuki; Kumakura, Yousuke; Morita, Kentaro; Ishiura, Tomoko; Shimizu, Kimiko; Fujieda, Yumiko; Ando, Shuntaro; Kondo, Shinsuke; Kasai, Kiyoto
2017-11-07
Personal recovery is increasingly recognised as an important outcome measure in mental health services. This study aimed to develop a Japanese version of the Questionnaire about the Process of Recovery (QPR-J) and test its validity and reliability. The study comprised two stages that employed the cross-sectional and prospective cohort designs, respectively. We translated the questionnaire using a standard translation/back-translation method. Convergent validity was examined by calculating Pearson's correlation coefficients with scores on the Recovery Assessment Scale (RAS) and the Short-Form-8 Health Survey (SF-8). An exploratory factor analysis (EFA) was conducted to examine factorial validity. We used intraclass correlation and Cronbach's alpha to examine the test-retest and internal consistency reliability of the QPR-J's 22-item full scale, 17-item intrapersonal and 5-item interpersonal subscales. We conducted an EFA along with a confirmatory factor analysis (CFA). Data were obtained from 197 users of mental health services (mean age: 42.0 years; 61.9% female; 49.2% diagnosed with schizophrenia). The QPR-J showed adequate convergent validity, exhibiting significant, positive correlations with the RAS and SF-8 scores. The QPR-J's full version, subscales, showed excellent test-retest and internal consistency reliability, with the exception of acceptable but relatively low internal consistency reliability for the interpersonal subscale. Based on the results of the CFA and EFA, we adopted the factor structure extracted from the original 2-factor model based on the present CFA. The QPR-J is an adequately valid and reliable measure of the process of recovery among Japanese users with mental health services.
Nederhof, Esther; Marceau, Kristine; Shirtcliff, Elizabeth A; Hastings, Paul D; Oldehinkel, Albertine J
2015-07-01
The present study is informed by the theory of allostatic load to examine how multiple stress responsive biomarkers are related to mental health outcomes. Data are from the TRAILS study, a large prospective population study of 715 Dutch adolescents (50.9 % girls), assessed at 16.3 and 19.1 years. Reactivity measures of the hypothalamic pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) biomarkers (heart rate, HR; respiratory sinus arrhythmia, RSA; and pre-ejection period, PEP) to a social stress task were used to predict concurrent and longitudinal changes in internalizing and externalizing symptoms. Hierarchical linear modeling revealed relatively few single effects for each biomarker with the exception that high HR reactivity predicted concurrent internalizing problems in boys. More interestingly, interactions were found between HPA-axis reactivity and sympathetic and parasympathetic reactivity. Boys with high HPA reactivity and low RSA reactivity had the largest increases in internalizing problems from 16 to 19 years. Youth with low HPA reactivity along with increased ANS activation characterized by both decreases in RSA and decreases in PEP had the most concurrent externalizing problems, consistent with broad theories of hypo-arousal. Youth with high HPA reactivity along with increases in RSA but decreases in PEP also had elevated concurrent externalizing problems, which increased over time, especially within boys. This profile illustrates the utility of examining the parasympathetic and sympathetic components of the ANS which can act in opposition to one another to achieve, overall, stress responsivity. The framework of allostasis and allostatic load is supported in that examination of multiple biomarkers working together in concert was of value in understanding mental health problems concurrently and longitudinally. Findings argue against an additive panel of risk and instead illustrate the dynamic interplay of stress physiology systems.
Betancourt, Theresa S; Brennan, Robert T; Rubin-Smith, Julia; Fitzmaurice, Garrett M; Gilman, Stephen E
2010-06-01
To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems (b = -1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance (b = -0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance (b = 1.93). Psychosocial interventions for former child soldiers may be more effective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended. 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Singh, Aakanksha; Mattoo, Surendra K.; Grover, Sandeep
2016-01-01
Background: Very few studies from India have studied stigma experienced by patients with schizophrenia. Aim of the Study: To study stigma in patients with schizophrenia (in the form of internalized stigma, perceived stigma and social-participation-restriction stigma) and its relationship with specified demographic and clinical variables (demographic variables, clinical profile, level of psychopathology, knowledge about illness, and insight). Materials and Methods: Selected by purposive random sampling, 100 patients with schizophrenia in remission were evaluated on internalized stigma of mental illness scale (ISMIS), explanatory model interview catalog stigma scale, participation scale (P-scale), positive and negative syndrome scale for schizophrenia, global assessment of functioning scale, scale to assess unawareness of mental disorder, and knowledge of mental illness scale. Results: On ISMIS scale, 81% patients experienced alienation and 45% exhibited stigma resistance. Stereotype endorsement was seen in 26% patients, discrimination experience was faced by 21% patients, and only 16% patients had social withdrawal. Overall, 29% participants had internalized stigma when total ISMIS score was taken into consideration. On P-scale, 67% patients experienced significant restriction, with a majority reporting moderate to mild restriction. In terms of associations between stigma and sociodemographic variables, no consistent correlations emerged, except for those who were not on paid job, had higher participation restriction. Of the clinical variables, level of functioning was the only consistent predictor of stigma. While better knowledge about the disorder was associated with lower level of stigma, there was no association between stigma and insight. Conclusion: Significant proportion of patients with schizophrenia experience stigma and stigma is associated with lower level of functioning and better knowledge about illness is associated with lower level of stigma. PMID:28066007
Community Mental Health Model for Campus Mental Health Services.
ERIC Educational Resources Information Center
Banning, James H.
University and college mental health services have historically modeled themselves after a traditional clinic model. Few delivery systems have been influenced by the community mental health model. The major reason for this lack of influence appears to be the "in loco parentis" stance of colleges and universities. A campus mental health service…
Husby, Ingrid Marie; Stray, Kaia Mølbach-Thellefsen; Olsen, Alexander; Lydersen, Stian; Indredavik, Marit Sæbø; Brubakk, Ann-Mari; Skranes, Jon; Evensen, Kari Anne I
2016-04-07
Being born with very low birth weight (VLBW: ≤ 1,500 g) is related to long-term disability and neurodevelopmental problems, possibly affecting mental health and health-related quality of life (HRQoL). However, studies in young adulthood yield mixed findings. The aim of this study was to examine mental health and HRQoL at 23 years, including changes from 20 to 23 years and associations with motor skills in VLBW young adults compared with controls. In a geographically based follow-up study, 35 VLBW and 37 term-born young adults were assessed at 23 years by using Achenbach Adult Self-Report (ASR), Short Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI) and various motor tests. The ASR and SF-36 were also used at 20 years. Longitudinal changes in ASR and SF-36 from 20 to 23 years were analysed by linear mixed models and associations with motor skills at 23 years by linear regression. At 23 years, total ASR score was 38.6 (SD: 21.7) in the VLBW group compared with 29.0 (SD: 18.6) in the control group (p = 0.048). VLBW participants had higher scores for attention problems, internalizing problems and critical items, and they reported to drink less alcohol than controls. BDI total score did not differ between groups. On SF-36, VLBW participants reported significantly poorer physical and social functioning, more role-limitations due to physical and emotional problems, more bodily pain and lower physical and mental component summaries than controls. In the VLBW group, total ASR score increased by 9.0 (95 % CI: 3.3 to 14.7) points from 20 to 23 years (p = 0.009 vs controls), physical and mental component summaries of SF-36 decreased by 2.9 (95 % CI: -4.8 to -1.1) and 4.4 (95 % CI: -7.1 to -1.7) points, respectively (p = 0.012 and p = 0.022 vs controls). Among VLBW participants, more mental health problems and lower physical and mental HRQoL were associated with poorer motor skills at 23 years. VLBW young adults reported poorer and declining mental health and HRQoL in the transitional phase into adulthood. They seemed to have a cautious lifestyle with more internalizing problems and less alcohol use. The associations of mental health problems and HRQoL with motor skills are likely to reflect a shared aetiology.
Bruce, Douglas; Stall, Ron; Fata, Aimee; Campbell, Richard T
2014-06-01
Sexual minority youth are more likely to experience homelessness, and homeless sexual minority youth report greater risk for mental health and substance abuse symptoms than homeless heterosexual youth, yet few studies have assessed determinants that help explain the disparities. Minority stress theory proposes that physical and mental health disparities among sexual minority populations may be explained by the stress produced by living in heterosexist social environments characterized by stigma and discrimination directed toward sexual minority persons. We used data from a sample of 200 young men who have sex with men (YMSM) (38 % African American, 26.5 % Latino/Hispanic, 23.5 % White, 12 % multiracial/other) to develop an exploratory path model measuring the effects of experience and internalization of sexual orientation stigma on depression and substance use via being kicked out of home due to sexual orientation and current homelessness. Direct significant paths were found from experience of sexual orientation-related stigma to internalization of sexual orientation-related stigma, having been kicked out of one's home, experiencing homelessness during the past year, and major depressive symptoms during the past week. Having been kicked out of one's home had a direct significant effect on experiencing homelessness during the past 12 months and on daily marijuana use. Internalization of sexual orientation-related stigma and experiencing homelessness during the past 12 months partially mediated the direct effect of experience of sexual orientation-related stigma on major depressive symptoms. Our empirical testing of the effects of minority stress on health of YMSM advances minority stress theory as a framework for investigating health disparities among this population.
Van Lieshout, Ryan J; Ferro, Mark A; Schmidt, Louis A; Boyle, Michael H; Saigal, Saroj; Morrison, Katherine M; Mathewson, Karen J
2018-04-18
Individuals born extremely preterm are exposed to significant perinatal stresses that are associated with an increased risk of psychopathology. However, a paucity of longitudinal studies has prevented the empirical examination of long-term, dynamic effects of perinatal adversity on mental health. Here, internalizing and externalizing problems from adolescence through adulthood were compared in individuals born at extremely low birth weight (ELBW; <1,000 g) and normal birth weight (NBW; >2,500 g). Internalizing and externalizing data were collected over 20 years in three waves, during adolescence, young adulthood, and adulthood. Growth models were used to compare longitudinal trajectories in a geographically based sample of 151 ELBW survivors and 137 NBW control participants born between 1977 and 1982 matched for age, sex, and socioeconomic status at age 8. After adjusting for sex, socioeconomic and immigrant status, and family functioning, ELBW survivors failed to show the normative, age-related decline in internalizing problems over time relative to their NBW peers (β = .21; p < .01). Both groups exhibited small declines in externalizing problems over the same period. Self-esteem (but not physical health, IQ, or maternal mood) partially mediated the association between ELBW status and internalizing problems. Extremely low birth weight survivors experienced a blunting of the expected improvement in depression and anxiety from adolescence to adulthood. These findings suggest that altered physiological regulatory systems supporting emotional and cognitive processing may contribute to the maintenance of internalizing problems in this population. © 2018 Association for Child and Adolescent Mental Health.
Trub, Leora; Quinlan, Ella; Starks, Tyrel J; Rosenthal, Lisa
2017-09-01
With increasing numbers of same-sex couples raising children in the United States, discriminatory attitudes toward children of same-sex parents (ACSSP) are of increasing concern. As with other forms of stigma and discrimination, lesbian, gay, and bisexual (LGB) individuals are at risk for internalizing these societal attitudes, which can negatively affect parenting-related decisions and behaviors and the mental and physical health of their children. Secure attachment is characterized by positive views of the self as loveable and worthy of care that are understood to develop in early relationships with caregivers. Secure attachment has been associated with positive mental and physical health, including among LGB individuals and couples. This study aimed to test the potential buffering role of secure attachment against stigma internalization by examining associations among secure attachment, discrimination, internalized homonegativity (IH), and ACSSP in an online survey study of 209 U.S. adults in same-sex relationships. Bootstrap analyses supported our hypothesized moderated mediation model, with secure attachment being a buffer. Greater discrimination was indirectly associated with more negative ACSSP through greater IH for individuals with mean or lower levels, but not for individuals with higher than average levels of secure attachment, specifically because among those with higher levels of secure attachment, discrimination was not associated with IH. These findings build on and extend past research, with important implications for future research and clinical work with LGB individuals, same-sex couples, and their families, including potential implementation of interventions targeting attachment security. © 2016 Family Process Institute.
Terada, Kazunori; Yamada, Seiji
2017-01-01
Humans use two distinct cognitive strategies separately to understand and predict other humans' behavior. One is mind-reading, in which an internal state such as an intention or an emotional state is assumed to be a source of a variety of behaviors. The other is behavior-reading, in which an actor's behavior is modeled based on stimulus-response associations without assuming internal states behind the behavior. We hypothesize that anthropomorphic features are key for an observer switching between these two cognitive strategies in a competitive situation. We provide support for this hypothesis through two studies using four agents with different appearances. We show that only a human agent was thought to possess both the ability to generate a variety of behaviors and internal mental states, such as minds and emotions (Study 1). We also show that humans used mixed (opposing) strategies against a human agent and exploitative strategies against the agents with mechanical appearances when they played a repeated zero-sum game (Study 2). Our findings show that humans understand that human behavior is varied; that humans have internal states, such as minds and emotions; that the behavior of machines is governed by a limited number of fixed rules; and that machines do not possess internal mental states. Our findings also suggest that the function of mind-reading is to trigger a strategy for use against agents with variable behavior and that humans exploit others who lack behavioral variability based on behavior-reading in a competitive situation. PMID:28736536
Jones, Adrian; Scannell, Tony
2002-04-01
The need for evidence-based practice (EBP) to guide and develop mental health services remains fundamental for modern services. Aim. To discuss issues that impact upon implementation of EBP and practice development using family work (FW) as an example. A selection of the FW literature was reviewed drawing on sources including the Cochrane Library, Cinahl and Medline. Keywords used were FW, community mental health team and research design. Centralized policy initiatives and guidelines that are themselves guided by evidence of randomized controlled trials predominantly risk alienating practitioners and clients/carers. Family work has some demonstrable clinical benefits although models differ and the active therapeutic agent remains unclear. Its adoption into routine care is also hindered by a productivity management outlook that seeks to maximize stretched resources and whose values are likely to be internalized by practitioners. The dichotomous position of previous research and practice development make implementation of EBP difficult and highlights the need for strategic planning that embraces both factors. The current drive to increase EBP requires a bi-directional process of influence that allows individual practitioners and clients/carers to become producers of evidence and not simply recipients. The authors support wider adoption of case study research designs to reflect the unpredictable nature of mental health care. Adoption of assertive community treatment models within community services is most likely to promote the excellence management model and accommodate EBP such as FW.
Wong, Y Joel; Tsai, Pei-Chun; Liu, Tao; Zhu, Qingqing; Wei, Meifen
2014-10-01
This study examined male Asian international college students' perceptions of racial discrimination, subjective masculinity stress, centrality of masculine identity, and psychological distress by testing a moderated mediation model. Participants were 160 male Asian international college students from 2 large public universities. Participants' perceived racial discrimination was positively related to their subjective masculinity stress only at high (but not low) levels of masculine identity centrality. Additionally, subjective masculinity stress was positively related to psychological distress, although this association was stronger among those who reported high levels of masculine identity centrality. The authors also detected a moderated mediation effect in which subjective masculinity stress mediated the relationship between perceived racial discrimination and psychological distress only at high (but not low) levels of masculine identity centrality. These findings contribute to the counseling psychology literature by highlighting the connections between race- and gender-related stressors as well as the relevance of masculine identity to an understanding of men's mental health. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Psychology of knowledge representation.
Grimm, Lisa R
2014-05-01
Every cognitive enterprise involves some form of knowledge representation. Humans represent information about the external world and internal mental states, like beliefs and desires, and use this information to meet goals (e.g., classification or problem solving). Unfortunately, researchers do not have direct access to mental representations. Instead, cognitive scientists design experiments and implement computational models to develop theories about the mental representations present during task performance. There are several main types of mental representation and corresponding processes that have been posited: spatial, feature, network, and structured. Each type has a particular structure and a set of processes that are capable of accessing and manipulating information within the representation. The structure and processes determine what information can be used during task performance and what information has not been represented at all. As such, the different types of representation are likely used to solve different kinds of tasks. For example, structured representations are more complex and computationally demanding, but are good at representing relational information. Researchers interested in human psychology would benefit from considering how knowledge is represented in their domain of inquiry. For further resources related to this article, please visit the WIREs website. The author has declared no conflicts of interest for this article. © 2014 John Wiley & Sons, Ltd.
Patients' mental models and adherence to outpatient physical therapy home exercise programs.
Rizzo, Jon
2015-05-01
Within physical therapy, patient adherence usually relates to attending appointments, following advice, and/or undertaking prescribed exercise. Similar to findings for general medical adherence, patient adherence to physical therapy home exercise programs (HEP) is estimated between 35 and 72%. Adherence to HEPs is a multifactorial and poorly understood phenomenon, with no consensus regarding a common theoretical framework that best guides empirical or clinical efforts. Mental models, a construct used to explain behavior and decision-making in the social sciences, may serve as this framework. Mental models comprise an individual's tacit thoughts about how the world works. They include assumptions about new experiences and expectations for the future based on implicit comparisons between current and past experiences. Mental models play an important role in decision-making and guiding actions. This professional theoretical article discusses empirical research demonstrating relationships among mental models, prior experience, and adherence decisions in medical and physical therapy contexts. Specific issues related to mental models and physical therapy patient adherence are discussed, including the importance of articulation of patients' mental models, assessment of patients' mental models that relate to exercise program adherence, discrepancy between patient and provider mental models, and revision of patients' mental models in ways that enhance adherence. The article concludes with practical implications for physical therapists and recommendations for further research to better understand the role of mental models in physical therapy patient adherence behavior.
The mental health of Indigenous peoples in Canada: A critical review of research.
Nelson, Sarah E; Wilson, Kathi
2017-03-01
Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world. Copyright © 2017 Elsevier Ltd. All rights reserved.
Do we have an internal model of the outside world?
Land, Michael F.
2014-01-01
Our phenomenal world remains stationary in spite of movements of the eyes, head and body. In addition, we can point or turn to objects in the surroundings whether or not they are in the field of view. In this review, I argue that these two features of experience and behaviour are related. The ability to interact with objects we cannot see implies an internal memory model of the surroundings, available to the motor system. And, because we maintain this ability when we move around, the model must be updated, so that the locations of object memories change continuously to provide accurate directional information. The model thus contains an internal representation of both the surroundings and the motions of the head and body: in other words, a stable representation of space. Recent functional MRI studies have provided strong evidence that this egocentric representation has a location in the precuneus, on the medial surface of the superior parietal cortex. This is a region previously identified with ‘self-centred mental imagery’, so it seems likely that the stable egocentric representation, required by the motor system, is also the source of our conscious percept of a stable world. PMID:24395972
Toms, Jonathan
2015-01-01
The Foucauldian sociologist Nikolas Rose has influentially argued that psychosocial technologies have offered means through which the ideals of democracy can be made congruent with the management of social life and the government of citizens in modern Western liberal democracies. This interpretation is contested here through an examination of the 1948 International Congress on Mental Health held in London and the mental hygiene movement that organised it. It is argued that, in Britain, this movement’s theory and practice represents an uneasy and ambiguous attempt to reconcile visions of ‘the modern’ with ‘the traditional’. The mental hygienist emphasis on the family is central. Here it appears as a forcing-house of the modern self-sustaining individual. Mental hygienists cast the social organisation of ‘traditional’ communities as static, with rigid authority frustrating both social progress and the full emergence of individual personality. Yet mental hygienists were also concerned about threats to social cohesion and secure personhood under modernity. If the social organisation of ‘traditional’ communities was patterned by the archetype of the family, with its personal relations of authority, mental hygienists compressed these relations into the ‘private’ family. Situated here they became part of a developmental process of mental adjustment through which ‘mature’, responsible citizens emerged. This reformulation of the family’s centrality for the social order informed mental hygienist critiques of the growth of state power under existing forms of democracy, as well as suspicion of popular political participation or protest, and of movements towards greater egalitarianism. PMID:26379371
Human rights of persons with mental illness in Indonesia: more than legislation is needed
Irmansyah, I; Prasetyo, YA; Minas, H
2009-01-01
Background Although attention to human rights in Indonesia has been improving over the past decade, the human rights situation of persons with mental disorders is still far from satisfactory. The purpose of this paper is to examine the legal framework for protection of human rights of persons with mental disorder and the extent to which Indonesia's international obligations concerning the right to health are being met. Methods We examined the Indonesian constitution, Indonesian laws relevant to the right to health, the structure and operation of the National Human Rights Commission, and what is known about violations of the human rights of persons with mental illness from research and the media. Results The focus of the Indonesian Constitution on rights pre-dated the Universal Declaration, Indonesia has ratified relevant international covenants and domestic law provides an adequate legal framework for human rights protections. However, human rights abuses persist, are widespread, and go essentially unremarked and unchallenged. The National Human Rights Commission has only recently become engaged in the issue of protection of the rights of persons with mental illness. Conclusion More than legislation is needed to protect the human rights of persons with mental illness. Improving the human rights situation for persons with mental illness in Indonesia will require action by governments at national, provincial and district levels, substantial increases in the level of investment in mental health services, coordinated action by mental health professionals and consumer and carer organisations, and a central role for the National Human Rights Commission in protecting the rights of persons with mental illness. PMID:19545362
Perspectives on perceived stigma and self-stigma in adult male patients with depression
Latalova, Klara; Kamaradova, Dana; Prasko, Jan
2014-01-01
There are two principal types of stigma in mental illness, ie, “public stigma” and “self-stigma”. Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is “self-stigma”. Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms (“boys don’t cry”) leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men’s feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional. PMID:25114531
Common mental disorders and subsequent work disability: a population-based Health 2000 Study.
Ahola, Kirsi; Virtanen, Marianna; Honkonen, Teija; Isometsä, Erkki; Aromaa, Arpo; Lönnqvist, Jouko
2011-11-01
Work disability due to common mental disorders has increased in Western countries during the past decade. The contribution of depressive, anxiety, and alcohol use disorders to all disability pensions at the population level is not known. Epidemiological health data from the Finnish Health 2000 Study, gathered in 2000-2001, was linked to the national register on disability pensions granted due to the ICD-10 diagnoses up to December 2007. Mental health at baseline was assessed using the Composite International Diagnostic Interview (CIDI). Sociodemographic, clinical, and work-related factors, health behaviors, and treatment setting were used as covariates in the logistic regression analyses among the 3164 participants aged 30-58 years. Anxiety, depressive, and comorbid common mental disorders predicted disability pension when adjusted for sex and age. In the fully adjusted multivariate model, comorbid common mental disorders, as well as physical illnesses, age over 45 years, short education, high job strain, and previous long-term sickness absence predicted disability pension. The study population included persons aged 30 or over. Sub groups according to mental disorders were quite small which may have diminished statistical power in some sub groups. Baseline predictors were measured only once and the length of exposure could not be determined. The systems regarding financial compensation to employees differ between countries. Comorbid mental disorders pose a high risk for disability pension. Other independent predictors of work disability include socio-demographic, clinical, work-related, and treatment factors, but not health behavior. More attention should be paid to work-related factors in order to prevent chronic work disability. Copyright © 2011 Elsevier B.V. All rights reserved.
Salom, Caroline L; Williams, Gail M; Najman, Jakob M; Alati, Rosa
2015-06-01
Substance and mental health disorders convey significant health burdens and impair interpersonal relationships. We tested associations between comorbid substance and mental health disorders and different forms of intimate partner violence (IPV) experienced by young adults. Mothers (n = 6703) were recruited during pregnancy to the longitudinal Mater-University of Queensland Study of Pregnancy. Mother/offspring dyads were followed up from birth to 21 years. Offspring with complete psychiatric data at 21 years who reported having had an intimate partnership were included (n = 1781). Participants' experiences of psychological, physical and severe combined IPV were assessed at 21 years using a summarised form of the Composite Abuse Scale. We used the Composite International Diagnostic Interview to obtain lifetime diagnoses of mental health and substance disorders. Multivariable logistic regression models of each IPV form were adjusted for individual, family and neighbourhood factors during adolescence, and for other forms of IPV. We have shown specific links between different forms of IPV experienced and individual substance and mental health disorders. Mental health disorders were related to all three forms of IPV, while alcohol disorders were linked to psychological IPV (ORAUD = 1.86; 1.21-2.86) and illicit substance disorders to physical IPV (ORSUD = 2.07; 1.25-3.43). The co-occurrence of related disorders was strongly linked to psychological and physical IPV. Intimate partner violence was experienced by both men and women. Substance and mental health disorders were associated with specific forms of IPV victimisation, suggesting that screening IPV clients and mental health/substance disorder patients for the converse problems may be important for intervention planning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
ERIC Educational Resources Information Center
Lim, Young-Jin
2014-01-01
There have been few research studies to examine the positive mental health of Asian adolescents. The aim here is to examine the factorial structure, internal consistency, test-retest reliability, and convergent/discriminant validity of a Korean version of the Mental Health Continuum-short form (K-MHC-SF), a newly developed self-report scale for…
Interns Addressing Mental Health Needs: Implementation of a Social and Emotional Education Program
ERIC Educational Resources Information Center
Fede, Jessica L.; Solomon, Benjamin G.; Whitcomb, Sara A.
2011-01-01
The estimated prevalence of one or more mental health disorders among children and adolescents between the ages of 9 and 17 is 21% (Satcher, 2001). Similarly, research by Greenberg et al., (2003) estimated that 20% of school-age youth experience mental health problems during the course of any school year. Despite these high prevalence rates, the…