Gender Nonconformity and Psychological Distress in Lesbians and Gay Men

Some lesbians and gay men tend to be more gender nonconforming, on average and for certain traits, than their heterosexual counterparts. Gender nonconformity in childhood has also been linked to adult homosexuality. Studies of both lesbians and gay men also find elevated rates of psychological distress. We hypothesized that these facts may be related. Individuals who violate social norms for gender-appropriate behavior may suffer from stigmatization by both heterosexual and homosexual people, leading to higher levels of psychological distress. We examined whether several measures of gender nonconformity were related to psychological distress in a community-based sample of gay men and lesbians. These included self-reports of childhood and adulthood gender nonconformity, as well as observer ratings of current behavior. Several measures of gender nonconformity were related to each other for both lesbians and gay men. In addition, gender nonconformity was related to psychological distress, but only for gay men. Finally, both lesbian and gay male participants reported more positive attitudes towards gender conformity than nonconformity, although the pattern was somewhat different for each group. We discuss the implications of these results for future studies of gender nonconformity and for the promotion of psychological health in lesbians and gay men.     

Ethnic inequalities in psychological distress among urban residents in the Netherlands: A moderating role of neighborhood ethnic diversity?

The main purpose of this study was to investigate whether neighborhood ethnic diversity moderated the association between ethnicity and psychological distress in the four largest cities of Netherlands. Multilevel linear regression analysis was used to assess whether the association between ethnicity and psychological distress differed by levels of neighborhood ethnic diversity. Results showed that the Turkish and Moroccan residents reported significantly higher psychological distress than native Dutch and Surinamese residents. In high ethnic diverse neighborhoods Turkish residents reported significantly less psychological distress than in low ethnic diverse neighborhoods. Ethnic diversity amplifies the risk of depression for some but not all ethnic minorities.     

Influences of income and employment on psychological distress and depression treatment in Japanese adults

Objectives  

Psychological distress is a health issue of critical importance, especially in people of working age in developed countries, including Japan. This study examined the relationships of income and employment arrangement with psychological distress and treatment of depression in a national sample of Japanese adults.     

Gender differences in trajectories of depressive symptomatology and substance use during the transition from adolescence to young adulthood

This study examines gender differences in the association between symptoms of depression and substance use during the transition from adolescence to young adulthood. Data are from three waves of the US-based National Longitudinal Study of Adolescent Health (n=10,828). Results from latent growth curve analysis demonstrate that the association between depressive symptomatology and substance use is bi-directional. Adolescents who are initially more depressed begin the study period with substantially higher levels of substance use than their better-adjusted peers, yet they are less vulnerable to increases in smoking (girls only), binge drinking (girls and boys), and illicit drug use (girls only) across the transition to young adulthood. Also, adolescents who start out with higher than average cigarette, alcohol, and illicit drug use experience a faster rate of decline in symptoms of depression over time compared to those who start out with lower levels of substance use. This association appears to be more pronounced for girls than for boys. Despite their faster rate of decline in depressive symptoms, girls and boys who have higher initial levels of substance use report higher levels of depressive symptomatology at all three time points.     

A multilevel analysis of the effects of neighbourhood income inequality on individual self-rated health in Hong Kong

We examined the effect on self-rated health of neighbourhood-level income inequality in Hong Kong, which has a high and growing Gini coefficient. Data were derived from two population household surveys in 2002 and 2005 of 25,623 and 24,610 non-institutional residents aged 15 or over. We estimated neighbourhood-level Gini coefficients in each of 287 Government Planning Department Tertiary Planning Units. We used multilevel regression analysis to assess the association of neighbourhood income inequality with individual self-perceived health status. After adjustment for both individual- and household-level predictors, there was no association between neighbourhood income inequality, median household income or household-level income and self-rated health. We tested for but did not find any statistical interaction between these three income-related exposures. These findings suggest that neighbourhood income inequality is not an important predictor of individual health status in Hong Kong.     

Gender and health care utilization: the role of mental distress and help-seeking propensity

Many studies report higher levels of health care utilization among women. Understanding how gender influences health care utilization is still unresolved. We developed a model that could explain these gender-related differences. The possible pathways assumed by this model that relate gender to utilization, can be summarized as follows: (1) utilization may be influenced by somatic morbidity, mental distress, perceived symptoms, poor subjective health and propensity to use services; (2) women have higher levels of these variables than men (mediating effect); and (3) the direct effects of some of these variables on utililization are moderated by gender, i.e. they are stronger for women than for men (moderating effect). Data were drawn from a community-based sample of adult enrollees of a sickness fund in the Netherlands, who had responded to a mailed health survey (N = 8698). This survey contained questions on somatic morbidity, mental distress and other mediating variables. Health care utilization was measured prospectively, using data extracted from a claims database held by the sickness fund that covers all types of general health services except general practitioner consultations. The model was tested using structural equation modelling. Women reported more somatic morbidity and mental distress than men did, as well as elevated levels of other mediating variables, which might explain-at least partly-gender related differences in utilization. Differences in propensity to use services were not found. The expected moderating effect of gender could not be demonstrated. That is, we did not find gender related differences in the strength of the relations between mental distress, other mediating variables and utilization. Mental distress is related to utilization in a way that is not gender specific, however, because women report higher levels of mental distress (as well as somatic morbidity), this results in a greater utilization of somatic health care services.     

The psychological effect of orphanhood in a matured HIV epidemic: An analysis of young people in Mukono,Uganda

As the HIV pandemic progresses, the number of orphans is expected to rise. Uganda is one of the countries that has been most impacted by the pandemic. A few studies have explored the effects of orphanhood on psychological well-being; however, most of these studies have not explored potential pathways through which orphanhood could affect psychological well-being. Using a school-based sample, this study sought to examine the differences in depressive symptoms and hopelessness between orphans and non-orphans in Mukono District, Uganda. The study also explored the potential mediating role of the family environment. The study included 1500 young people from 10 randomly selected schools in Mukono Town Council. Data on school characteristics also were collected from the head teachers or their designees. Linear regression methods were used for multivariate models. We found that orphanhood was associated with psychological ill health among the males. Male double and male maternal orphans had a significantly higher level of hopelessness than their non-orphaned counterparts. Male double orphans also had more depressive symptoms, but this association was mediated by the family environment. No differences were noted between orphaned and non-orphaned females. The cause and timing of parental death was important only among the males, and loss of a parent to HIV was associated with worse psychological outcomes among the males and not the females. Lower parent/guardian connectedness, having a chronically ill adult in the household and ill treatment in residence were associated with a higher level of depression, especially among the males. The data show that the effect of orphanhood on psychological outcomes may vary by gender and type of outcome. This study also suggests an attenuated effect of orphanhood on psychological well-being among school-going youth. Programs seeking to improve psychological well-being among youth must pay attention to the family situations of these youth.     

Policy implications of neighbourhood effects on health research: towards an alternative to poverty deconcentration

While researchers build an evidence that where one lives has an independent effect on their health, the work of translating this research into effective policies is impeded by problematic assumptions about urban poverty. In light of new experimental studies on the health effects of neighbourhoods using housing mobility programs, this paper addresses the politics of poverty deconcentration that implicitly undergirds much of this new research. By raising critiques of these programs that are rarely considered in the health literature, this paper challenges the central treatment of poverty dispersal in the new experimental literature. Poverty dispersal policies, without addressing the competitive urban structure, simply react to symptoms of poverty and ignore the underlying factors that shape the neighbourhood resources that structure health outcomes. These factors include municipal fragmentation, exclusionary land use planning, and municipal competition. Effective social policies aimed at improving neighbourhood influence on health must address the competitive and fragmented municipal structure that produces a patchwork of affluence and deprivation in today’s urban America.     

Mental health benefits of neighbourhood green space are stronger among physically active adults in middle-to-older age: Evidence from 260,061 Australians

Objective

While many studies report that green spaces promote mental health, some suggest the psychological benefits of physical activity are amplified if participation occurs within greener environs. We investigated whether this relationship could be observed among adults in middle-to-older age.

Method

Multilevel logit regression was used to investigate association between green space and psychological distress (Kessler scores of 22 +) among 260,061 Australians over 45 years old living in New South Wales (2006–2009). Physical activity was measured using the Active Australia survey. Percentage green space was estimated within a 1-kilometre of residence.

Results

In comparison to residents of the least green areas, those in the greenest neighbourhoods were at a lower risk of psychological distress (Odds Ratio 0.83, 95% CI: 0.76, 0.92) and were less sedentary (0.81: 0.77, 0.87). An interaction was observed between physical activity and green space (p = 0.0028). More green space did not appear to benefit mental health among the least active (0.99: 0.85, 1.15), but there was a protective association for the more physically active (0.82: 0.67, 0.99).

Conclusion

For adults in middle-to-older age, green spaces are not only important for promoting physical activity, but the mental health benefits of greener environs appear contingent upon those active lifestyles.     

不同系统功能性躯体症状与心理症状的关系

目的　了解不同系统功能性躯体症状 (FSS)和心理症状的相互关系。方法　用以SCL - 90和CMI为基础修订的自评心理和躯体症状问卷及一般情况调查表 ,调查某软件企业来医院体检的青年职工 4 5 0例。结果　⑴不同系统FSS(五官、呼吸、循环、消化、神经肌肉、皮肤、疲劳 )和不同心理症状 (强迫、人际敏感、抑郁、焦虑、敌意、恐怖、偏执 )出现的构成比不同 (7 2 %～ 34 6 % )。⑵不同系统FSS合并出现的主要心理症状不同 ,如循环系统FSS被试同时存在人际敏感、焦虑、恐惧的可能性较大 ;而消化系统FSS被试则同时存在抑郁、恐怖、偏执的机会较大。⑶就诊次数与除皮肤、疲劳外的 5项FSS因子相关明显 (P <0 0 5 )。结论　正确识别和处理不同系统FSS及其可能合并的不同的心理症状是临床各科医师共同的任务     

心理疏导对维、汉民族冠心病患者改善抑郁情绪疗效的比较

目的研究心理疏导对维、汉不同民族冠心病患者抑郁症症状的改善情况和二者之间的差异。方法随机选取已确诊冠心病的维、汉患者各40例给与冠心病标准药物治疗的同时进行心理疏导治疗,治疗前、治疗3个月、治疗6个月均进行SDS测评,将测评结果进行组间及组内比较,以P<0.05为具有统计学差异。结果两组患者与各自治疗前比较,SDS评分均较治疗前有明显降低,且维族冠心病组评分降低甚至低于汉族冠心病组。结论心理疗法能减轻冠心病患者的抑郁症状,维族冠心病患者心理疗法的效果强于汉族组,提示在不同民族心理治疗的效果不同。     

妇产科手术患者术前心理状态分析

目的分析妇产科患者手术前的抑郁焦虑情况,探讨引起患者抑郁、焦虑的因素。方法采用zung评定抑郁量表(SDS)及zung评定焦虑量表(SAS)对65例妇产科手术患者术前的抑郁、焦虑状态进行测定,并对手术治疗与非手术治疗患者不同手术类型、文化程度、职业类型的抑郁焦虑状态进行分析。结果所测手术患者63.08%有抑郁、36.92%有焦虑、16.92%抑郁、焦虑均有:抑郁、焦虑程度与手术类型、文化程度、职业,而与年龄大小无关。结论手术前应针对各种不同类型患者进行有效的心理护理。     

How does neighbourhood socio-economic status affect the interrelationships between functioning dimensions in first episode of psychosis? A network analysis approach

The links between psychosis and socio-economic disadvantage have been widely studied. No previous study has analysed the interrelationships and mutual influences between functioning dimensions in first episode of psychosis (FEP) according to their neighbourhood household income, using a multidimensional and transdiagnostic perspective. 170 patients and 129 controls, participants in an observational study (AGES-CM), comprised the study sample. The WHO Disability Assessment Schedule (WHODAS 2.0) was used to assess functioning, whereas participants' postcodes were used to obtain the average household income for each neighbourhood, collected by the Spanish National Statistics Institute (INE). Network analyses were conducted with the aim of defining the interrelationships between the different dimensions of functioning according to the neighbourhood household income. Our results show that lower neighbourhood socioeconomic level is associated with lower functioning in patients with FEP. Moreover, our findings suggest that “household responsibilities” plays a central role in the disability of patients who live in low-income neighbourhoods, whereas “dealing with strangers” is the most important node in the network of patients who live in high-income neighbourhoods. These results could help to personalize treatments, by allowing the identification of potential functioning areas to be prioritized in the treatment of FEP according to the patient's neighbourhood characteristics.