What's Unique About Lesbian,Gay, Bisexual,and Transgender (LGBT) Youth and Young Adult Suicides? Findings From the National Violent Death Reporting System

Purpose

The purpose of the study was to explore variability in circumstances around suicide deaths among youth and young adults by sexual/gender identity category (gay male, lesbian/gay female, bisexual male, bisexual female, transgender male, transgender female, non–LGBT [lesbian, gay, bisexual, and transgender] male, and non-LGBT female).

Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey

ObjectivesUnderstanding the factors influencing mothers’ decision to breastfeed their infants is essential to formulate effective breastfeeding interventions. This study explored the determinants of optimal breastfeeding indicators in Indonesia.MethodsWe used the 2017 Indonesia Demographic and Health Survey to analyze factors associated with early initiation of breastfeeding, exclusive breastfeeding (EBF), and continued breastfeeding at 1 year (CBF-1) and 2 years (CBF-2). Multivariate logistic regression models were used to examine bio-demographic, socio-cultural, and behavioral characteristics associated with breastfeeding after considering the survey design effect.ResultsThe risk of delayed breastfeeding initiation was higher among infants who were born smaller, first-born children, were delivered via cesarean delivery, and did not have immediate skin-to-skin contact (p<0.01). Infant’s age, birth pattern, household wealth index, and the mother’s occupation and smoking status were predictors of EBF (p<0.05). CBF-1 was less common among first-time mothers and those working in the non-agricultural sector, mothers from wealthier families, and mothers who had cesarean deliveries (p<0.01). Infant’s age was negatively associated with CBF-2 (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.74 to 0.99). Mothers attending college were less likely to practice CBF-2 than those with no education or primary education (aOR, 0.45; 95% CI, 0.26 to 0.77). The absence of postnatal visits was a risk factor for CBF-1 and CBF-2 (p<0.05).ConclusionsBreastfeeding interventions in Indonesia should pay particular attention to at-risk groups such as women from wealthier families, working outside the agricultural sector, and with a higher education level. Nutrition-sensitive programs (e.g., postnatal care and smoking cessation) should also be encouraged.     

我国七大城市中学生情绪抑郁的现状

作者采用ReynoldsAdolescentDenressionScale（RADS）量表测查了我国上海、广州、武汉、西安、昆明、沈阳、太原等七大城市3905名中学生的抑郁情绪。量表总均分为52．87，女生高于男生（P＝0．000）．重点中学与普通中学间无显著性差异；但其中学校焦虑等7个条目各均分，普通校显著高于重点校，疲劳感与睡眠障碍的均分．则以重点校为高。量表总分随年级增高而上升，初中阶段增加最快。七大城市各总分间差异性显著（P＝0．000），以武汉为最高。RADS量表复测信度为0．79、分半信度为0．88；与流调抑郁量表间相关系数为0．84，表明RADS有较好的信度、效度。RADS是测查青春期情绪抑郁的良好筛查工具。     

Complex Health Needs in the Youth Justice System: A Survey of Community-Based and Custodial Offenders

PurposeEstimate the prevalence and annual frequency of health risk indicators in young people serving community-based orders (CBOs) and custodial orders in the state of Victoria, Australia.MethodsCross-sectional survey of 242 young people serving CBOs and 273 serving custodial orders in Victoria in 2002–2003. Validated measures included the Composite International Diagnostic Interview for substance dependence, Short Mood and Feelings Questionnaire for depression, and Psychosis Screening Questionnaire for psychosis symptoms. Prevalence estimates were adjusted for sampling bias and age- and sex-adjusted for between-group comparisons. Prevalence estimates were applied to 2010–2011 Victorian youth justice data to estimate annual frequencies at the state level.ResultsThe prevalence of substance dependence, poor mental health, and risky sexual behavior was high in both groups. Age- and sex-adjusted prevalence estimates were generally higher among those serving custodial orders; however, extrapolating prevalence estimates to statewide youth justice data generally resulted in higher estimated annual frequencies among CBOs. For example, the estimated prevalence of any substance dependence was 66% (95% confidence interval [CI], 60–72) in those serving custodial orders and 34% (95% CI, 26–42) in CBOs, but the estimated frequency of substance dependence in CBOs in 2010–2011 was 970 (95% CI, 750–1,180), compared with 490 (95% CI, 450–530) in those serving a custodial order.ConclusionsThere is a compelling case for scaling up health services for young offenders in custody and in the community, and for routinely monitoring the health of young offenders serving custodial and community orders.     

江汉大学学生抑郁状况调查

目的了解大学生抑郁状态发生情况和严重程度,为制定有针对性的预防和控制措施提供科学依据。方法采用分层整群抽样法抽取江汉大学1681名本科学生,采用抑郁自评量表（SDS）进行测评。结果1681名大学生中,存在不同程度抑郁状态的占23.80%,其中轻度占65.75%,中度占23.50%,重度占10.75%;文科生与理科生之间差异有统计学意义,男生与女生、城镇学生与农村学生差异均无统计学意义。结论大学生抑郁状态检出率较高,应加强对大学生的心理健康教育和心理危机干预。     

家庭健康促进视角下青少年抑郁的代际传递研究——基于CFPS2018的实证分析

目的：基于家庭健康促进视角,探究青少年抑郁的代际传递,为青少年心理健康促进提供理论和政策依据。方法：基于2018年CFPS数据,使用线性回归模型和Shapley值分解法分析父母抑郁水平对青少年抑郁水平的影响及其相对贡献度;利用中介和调节效应分析探讨父母日常关怀和家庭结构在抑郁代际传递中的作用机制。结果：父母抑郁水平显著影响青少年抑郁水平;亲子系统对青少年抑郁的相对贡献度最高;父母抑郁水平可通过青少年感知到的行踪关注来影响青少年抑郁水平;父母对青少年的学习和生活关怀可弱化父母抑郁对青少年抑郁的影响;与完整家庭相比,单亲家庭的抑郁代际传递效应更强。结论：青少年抑郁水平受其父母抑郁水平及所处家庭环境的影响,建议重视家庭心理健康建设,协同推进青少年心理健康促进与家庭教育形成政策合力。     

医科大学生抑郁的研究现状

抑郁是大学生自杀的首要原因,是医科大学生常见的心理健康问题。该文从医学生抑郁的国内外现状、影响因素以及干预研究等方面对现有的研究情况进行了综述,并提出医学生抑郁今后的研究方向,以促进抑郁研究的进一步开展。     

Labeling of mental disorders and stigma in young people

Mental disorders are common in young people, yet many do not seek help. The use of psychiatric labels to describe mental disorders is associated with effective help-seeking choices, and is promoted in community awareness initiatives designed to improve help-seeking. However these labels may also be coupled with stigmatizing beliefs and therefore inhibit help-seeking: lay mental health or non-specific labels may be less harmful. We examined the association between labeling of mental disorders and stigma in youth using data from a national telephone survey of 2802 Australians aged 12-25 years conducted from June 2006 to August 2006. Label use and stigmatizing beliefs were assessed in response to vignettes of a young person experiencing depression, psychosis or social phobia. Logistic regressions examined the association between a range of labels commonly used, including psychiatric labels, and a range of stigma components. There were no significant associations between label use and the stigma components of "stigma perceived in others", "reluctance to disclose" and for the most part "social distance". Most mental health labels were associated with seeing the person as "sick" rather than "weak" and accurate psychiatric labels had the strongest effect sizes. However, for the psychosis vignette, the "dangerous/unpredictable" component was predicted by the labels "schizophrenia/psychosis", "mental illness" and "psychological problem", and the accurate psychiatric label showed the strongest association. For all vignettes, generic lay labels were not associated with stigma, but also rarely had a counter stigma effect. These findings suggest that the use of accurate psychiatric labels by young people is seldom associated with stigma and may assist young people by reducing perceptions of weakness. However, community education that promotes accurate labeling of psychosis should proceed with caution and address beliefs about dangerousness and unpredictability.     

Social Determinants and Health Service Use Among Racial and Ethnic Minorities: Findings From a Community Sample

Multiple models conceptualizing the relationship between social determinants and health exist, but little research has examined the relationship between social determinants and health service use. Using previously collected survey data from racial and linguistic minorities from high-crime communities in a Midwestern urban area, this study uses the Commission on Social Determinants of Health framework to test the structural and intermediary determinants of health service use. The results indicate that perceived discrimination and neighborhood cohesion increase the likelihood of a person using health services. Implications for social work practice, advocacy, and research to address intermediary social determinants are discussed.     

产后抑郁对子女心理发展的影响

产后抑郁是女性分娩后出现的常见精神疾患,其不仅影响女性的生活与家庭关系,还对其子女的心理发展产生影响.通过抑郁母亲对子女影响的整合模型,介绍了母亲抑郁从遗传、生理和神经功能变化、育儿方式以及社会生活中的压力源4个途径对子女心理发展产生影响的机制.同时提出母亲抑郁的严重程度、儿童自身特点和家庭环境因素对这一过程的调节作用,以期为有效减轻母亲抑郁症状对儿童心理发展不良影响提供干预和治疗的依据.     

未婚流动青年性与生殖健康服务提供的困惑:来自供需双方的声音

目前中国未婚流动青年的生殖健康服务可及性不高,从供需双方来讲,未婚流动青年和医疗卫生人员都有各自的困惑。未婚流动青年对提供生殖健康服务的医疗卫生机构认识不足。因为隐私、医疗卫生人员态度、时间等问题,有些未婚流动青年倾向去私人诊所看病。医疗卫生人员为他们提供服务多是被动、不全面的。未婚流动青年的生殖健康问题和心理问题密切相关,往往交织在一起。通过供需双方做对比,凸显出未婚流动青年生殖健康服务提供的矛盾和误区。     

Residential Transience and Depression: Does the Relationship Exist for Men and Women?

Residential transience may contribute to adverse mental health. However, to date, this relationship has not been well-investigated among urban, impoverished populations. In a sample of drug users and their social network members (n = 1,024), we assessed the relationship between transience (frequently moving in the past 6 months) and depressive symptoms, measured by the CES-D, among men and women. Even after adjusting for homelessness, high levels of depressive symptoms were 2.29 [95%CI = 1.29-4.07] times more likely among transient men compared to nontransient men and 3.30 [95% CI = 1.10-9.90] times more common among transient women compared to nontransient women. Stable housing and mental health services need to be available, easily accessible, and designed so that they remain amenable to utilization under transient circumstances.     

Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey

PURPOSE

The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients’ willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample.

METHODS

We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately.

RESULTS

Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68–7.81), general health tips (OR = 2.03; 95% CI, 1.74–2.38), medication reminders (OR = 2.73; 95% CI, 2.35–3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62–1.92), vital signs (OR = 1.63; 95% CI, 1.48–1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24–1.58), and symptoms (OR = 1.62; 95% CI, 1.46–1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information.

CONCLUSIONS

Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication.     

Adolescents' Perceived Socio-Emotional Impact of COVID-19 and Implications for Mental Health: Results From a U.S.-Based Mixed-Methods Study

PurposeCOVID-19 has disrupted many aspects of adolescents' lives, yet little data are available that document their subjective experiences of the pandemic. In a mixed-methods study of U.S. adolescents, we examined (1) adolescents' perceptions of how their social and emotional lives had changed during COVID-19; and (2) associations between these perceived changes and indices of their mental health, above and beyond their prepandemic mental health status.MethodsFour hundred seven U.S. adolescents (M_age = 15.24, standard deviation = 1.69; 50% female; 52%, 20% African American, 17% Hispanic/Latinx) completed surveys before (October 2019) and during (April 2020) the COVID-19 pandemic. They provided qualitative and quantitative responses on their experiences with COVID-19 and reports of their mental health.ResultsAdolescents perceived various changes in their relationships with family and friends (e.g., less perceived friend support) during COVID-19. They also perceived increases in negative affect and decreases in positive affect. These perceived social and emotional changes were associated with elevated depressive symptoms, anxiety symptoms, and loneliness in April 2020, controlling for mental health problems before the pandemic.ConclusionsOur findings sensitize clinicians and scholars to the vulnerabilities (changes in friendship dynamics), as well as resiliencies (supportive family contexts), presented to U.S. adolescents during the early months of COVID-19.     

Identifying Potential Risk and Protective Factors among Non-Metropolitan Latino Youth: Cultural Implications for Substance Use Research

Immigration studies show that the social adaptation of second-generation youth is conditioned by the pace of acculturation among parents and children, cultural and economic barriers, and family and community resources for confronting barriers. This research, however, has primarily focused on the link between acculturation and acculturative stress on Latino adolescents residing in large urban communities. There is a lack of research on the social integration of Latino youth living in rapidly expanding non-metropolitan communities. Consequently, we explored cultural aspects and potential risk and protective factors for early onset of alcohol use for Latino youth. Our findings indicate these rural Latino youth face unique and common stressors compared to urban youth that place them at risk for alcohol use. Cultural expectations surrounding substance use, however, may serve as protective factors to substance use for Latino youth, particularly girls.     

Educating Youth About Health and Science Using a Partnership Between an Academic Medical Center and Community-based Science Museum

Declining student interest and scholastic abilities in the sciences are concerns for the health professions. Additionally, the National Institutes of Health is committed to promoting more research on health behaviors among US youth, where one of the most striking contemporary issues is obesity. This paper reports findings on the impact of a partnership between Oregon Health and Science University (OHSU) and the Oregon Museum of Science and Industry linked to a 17-week exhibition of BodyWorlds3 and designed to inform rural underserved youth about science and health research. Self-administered survey measures included health knowledge, attitudes, intended health behaviors, and interest in the health professions. Four hundred four surveys (88% of participants) were included in analyses. Ninety percent or more found both the BodyWorlds (n = 404) and OHSU (n = 239) exhibits interesting. Dental care habits showed the highest level of intended behavior change (Dental = 45%, Exercise = 34%, Eating = 30%). Overall, females and middle school students were more likely than male and high school students, respectively, to state an intention to change exercise, eating and dental care habits. Females and high school students were more likely to have considered a career in health or science prior to their exhibit visit and, following the exhibit, were more likely to report that this intention had been reinforced. About 6% of those who had not previously considered a career in health or science (n = 225) reported being more likely to do so after viewing the exhibits. In conclusion, high quality experiential learning best created by community-academic partnerships appears to have the ability to stimulate interest and influence intentions to change health behaviors among middle and high school students.     

From the family universe to the outside world: Family relations, school attitude, and perception of racism in Caribbean and Filipino adolescents

Caribbean and Filipino immigrant families in Canada have much in common: the women have often immigrated as domestic workers, first-generation children may be separated from their parents for long periods, and they must deal with negative stereotypes of their ethnic group. This transcultural study looks at the associations between family relations and adolescents’ perceptions of both their own group and the host society, and analyzes how these affect their mental health. The results suggest that family cohesion plays a key role in shaping adolescents’ perceptions of racism in the host country and in promoting a positive appraisal of their own community, thus highlighting the need for a systemic understanding of family and intergroup relations.     

Youth risk behaviour in a Chinese population: a territory-wide youth risk behavioural surveillance in Hong Kong

This cross-sectional study investigated the prevalence rates of different categories of youth risk behaviour by age, sex and parental education. The study population consisted of 26,111 Hong Kong students, aged 10-19 years, recruited from 48 primary (primary grades 4-6) and secondary schools (secondary grades 1-7). Less than one-third of subjects participated in vigorous exercise regularly, about one-third consumed an unhealthy diet frequently, 18% had tried smoking, and 14.5% had seriously considered attempting suicide. Although only 3.4% of students reported experience of sexual intercourse, less than half used a contraceptive device. Older students had higher prevalence rates of health-compromising behaviours than younger students. Female students were more likely to report suicide-related behaviour, attempting weight loss, and non-participation in vigorous physical activities. Students with parents of a lower educational background were more likely to report rarely or never wearing seat belts and bicycle helmets, suicide-related behaviour, smoking, sexual intercourse before 13 years of age, and attempting weight loss. The availability of data on youth health risk behaviours would enable health educators, public health practitioners and clinicians to plan appropriate screening and counselling for risk behaviours in early adolescents.     

School performance and alcohol use problems in early adulthood: a longitudinal study

There is inconsistent evidence about the association between school performance and subsequent use of alcohol and alcohol problems in adolescents and young adults. This study examines whether school performance at 14 years is associated with drinking problems in early adulthood; and whether this association is explained by family and individual factors in childhood and adolescence. Data were from a 21-year follow-up of 3,478 Australian young adults from birth to the age of 21 years when data on use of alcohol were collected. Child school performance (CSP) was assessed at 14 years via self- and maternal report. Alcohol consumption at 21 years was measured via self-report, and alcohol abuse and dependence were assessed by the computerized version of Composite International Diagnostic Interview (CIDI-Auto). Potential confounding factors were prospectively measured between the child’s birth and age of 14 years. School performance at 14 years predicted young adults’ alcohol consumption and alcohol use disorders (AUDs). After controlling for confounding, children who had lower school performance had increased risk of drinking more than two glasses of alcohol per day in early adulthood (odds ratio = 1.7; 95% confidence interval: 1.1–2.6). There was a similar pattern of association between CSP and young adults’ alcohol abuse and dependence (AUD) measured by CIDI-Auto. Level of academic performance in high school children predicts their drinking problems as young adults, independently of a selected group of individual and family confounders. Exploration of the pathway linking school performance and alcohol problems in young people may help identify opportunities for preventive interventions.     

Disparities in HIV Education and Testing Between Metropolitan and Nonmetropolitan Adolescents and Young Adults in the U.S.

PurposeTo examine receipt of formal sexual health education on Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and receipt of HIV testing in adolescents and young adults (AYAs) residing in nonmetropolitan versus metropolitan areas.MethodsA secondary data analysis of the 2015–2017 National Survey of Family Growth of AYAs ages 15–24 years (N = 3,114). Logistic regression models predicted associations between nonmetropolitan versus metropolitan status and outcomes of interest (formal sexual health education on HIV/AIDS and HIV testing).ResultsMost AYAs (85.3%) reported receiving formal sexual health education on HIV/AIDS, while less than half (46.9%) indicated receiving HIV testing. Residing in a nonmetropolitan area was associated with a lower odds of reporting formal sexual health education on HIV/AIDS (OR = .47, CI = [.29, .77]) but not with HIV testing (OR = 1.33, CI = [.89, 2.01]).ConclusionsAYAs living in nonmetropolitan areas are less likely to receive formal sexual health education on HIV/AIDS.