Adverse Childhood Experiences (ACEs), Stress and Mental Health in College Students

The goal of this short‐term longitudinal study was to examine whether adverse childhood experiences (ACEs) could be used to identify college students at risk for mental health problems and whether current level of stress mediates the relationship between ACEs and mental health. Data on ACEs and mental health (depression, anxiety and suicidality) were collected at the beginning of the semester, and data on current stressors and mental health were collected toward the end of the semester (n = 239). Findings indicated that ACEs predicted worsening of mental health over the course of a semester and suggested current number of stressors as a mediator of the relationship between ACEs and mental health. Results suggest that screening for ACEs might be useful to identify students at high risk for deterioration in mental health. Results further suggest that stress‐related interventions would be beneficial for students with high levels of ACEs and point to the need for more research and strategies to increase help‐seeking in college students.     

Effects of Intimate Partner Violence,Mental Health,and Relational Resilience on Perinatal Health

Intimate partner violence (IPV) during and prior to pregnancy has been linked to higher rates of pregnancy complications and early labor and delivery. However, to our knowledge, no studies have examined prenatal mental health problems and relational resilience as parallel mechanisms by which past‐year IPV exposure impacts pregnancy and labor. The current study aimed to (a) examine the contribution of IPV exposure to pregnancy complications and early labor and delivery, controlling for childhood adversity, and (b) assess prenatal mental health and relational resilience as mediators of the effect of IPV exposure on pregnancy complications and early labor and delivery. We hypothesized that IPV would predict higher levels of mental health problems and lower levels of relational resilience, each of which would contribute to women's risk of labor complications such that fewer mental health problems and higher levels of relational resilience would each be associated with fewer pregnancy complications and early labor and delivery. Participants were (n = 76) interviewed during pregnancy and 6 weeks postdelivery. No direct effect of IPV exposure on either pregnancy complications or labor complications was found. Parallel indirect effects of IPV on labor via prenatal mental health, indirect effect size = ?.09; 95% CI [?.224, ?.011]; and relational resilience, indirect effect size = .13, 95% CI [.036, .329] were found. Brief, empirically tested IPV screens at prenatal clinics may help healthcare providers better identify IPV‐exposed patients. Clinical interventions targeting prenatal mental health and relational resilience may help improve labor outcomes for IPV‐exposed mothers.     

Psychosocial Pathways Linking Adverse Childhood Experiences to Mental Health in Recently Deployed Canadian Military Service Members

Multiple pathways have been suggested to account for the relationship of adverse childhood experiences (ACEs) and well‐being in adulthood, including interpersonal difficulties, the underestimation of one's sense of mastery, and a greater propensity to experience stressors later in life. This study was conducted to examine the association between ACEs and mental health in Canadian Armed Forces (CAF) personnel, and the possible mediating roles of social support, mastery, and combat stressors in that relationship. The study consisted of a prospective analysis involving 3,319 CAF members upon their return from an overseas deployment. Results were that ACEs were associated with poorer mental health (β = ?.14, p < .001) and that approximately 42.6% of this relationship could be explained by the mediating effects of low social support, low mastery, and a greater number of combat stressors. The full model, including the covariates, ACEs, social support, mastery, and combat stressors as correlates of postdeployment mental health, was statistically significant with adjusted R² = .28, F(9, 3309) = 141.96, p < .001. On the whole, results suggested that social support, mastery, and life stressors may be possible targets for interventions to minimize the impact of ACEs on later mental health in military personnel.     

Adverse childhood experiences and sleep links in a predominantly Black sample of overweight adults

Adverse childhood experiences (ACEs) have been associated with worse sleep, but existing literature is limited by use of predominantly White samples, lack of objective sleep measurement, and use of non-standardized questionnaires. We investigated associations between retrospectively reported ACEs and sleep in adulthood in a sample of 43 adults 20–53 years of age, free from chronic conditions, with a Body mass index (BMI) ≥ 25 (Mean age = 33.14 [SD = 10.05], 74% female, 54% Black). Sleep efficiency (SE), total sleep time (TST), wake after sleep onset (WASO), and sleep onset latency (SOL), were measured by actigraphy and daily diary. Global sleep quality and insomnia severity were measured by questionnaires. Sleepiness, fatigue, and sleep quality were also measured by daily diary. Adjusting for demographic characteristics and BMI, ACEs were significantly associated with poorer global sleep quality and diary measures of greater daytime sleepiness, fatigue, and poorer sleep quality. There were no significant associations between ACEs and SE, TST, WASO, or SOL measured by diary or actigraphy. Findings suggest that ACEs are associated with worse sleep perception and daytime functioning in adulthood. Larger prospective studies are needed to replicate these findings, examine racial/ethnic differences, and determine temporal associations between ACEs, sleep, and health (e.g., BMI).     

Spirituality, Resilience, and Anger in Survivors of Violent Trauma: A Community Survey

This study evaluates the relationship between spirituality, resilience, anger and health status, and posttraumatic symptom severity in trauma survivors. A community sample (N = 1,200) completed an online survey that included measures of resilience, spirituality (general beliefs and reincarnation), anger, forgiveness, and hatred. In survivors of violent trauma (n = 648), these measures were evaluated with respect to their relationship to physical and mental health, trauma-related distress, and posttraumatic symptom severity. Using multivariate regression models, general spiritual beliefs and anger emerged in association with each outcome, whereas resilience was associated with health status and posttraumatic symptom severity only. Forgiveness, hatred, and beliefs in reincarnation were not associated with outcome. The importance of these findings to treating trauma survivors is discussed.     

The Potential Unique Impacts of Hope and Resilience on Mental Health and Well-Being in the Wake of Hurricane Harvey

Natural disasters can lead to mental health problems, such as posttraumatic stress disorder (PTSD). Higher levels of loss and/or disruption and prior trauma exposure constitute risk factors for mental illness, whereas protective factors, including hope and resilience, support positive functioning. The present cross-sectional study used structural equation modeling to examine the relative influence of resilience and hope on mental health and well-being 1–3 months after Hurricane Harvey made landfall in August 2017, among a sample of 829 adults in the Greater Houston, Texas area. Resilience was more strongly associated with reduced PTSD symptoms, β = −.31, 95% CI [−.42, −.21], than was hope, β = −.17, 95% CI [−;.30, −.04], whereas hope was more strongly associated with components of well-being, βs = .47–.63. Hope was positively associated with posttraumatic growth, β = .30, 95% CI [.19, .41], whereas resilience was negatively associated with posttraumatic growth, β = −.24, 95% CI [−.35, −.12]. These associations remained consistent after considering risk factors, although more variance in trauma-related outcomes was risk factors were included in the model. The present results suggest that considering the influence of both risk and resilience factors provides an enhanced picture of postdisaster mental health.     

Gender composition of the occupation,sexual orientation,and mental health in young adulthood

The gender composition of the occupation has important implications for work conditions, rewards, and experiences, but little is known about whether it impacts workers' mental health. The present study seeks to answer this question by focusing on depressive symptoms and drug dependence symptoms as mental health outcomes and young adulthood as the life course context. The study further examines whether the association varies by sexual orientation, considering that occupational gender composition affects levels of stress exposure and social support availability in different ways for heterosexuals and sexual minorities. The analysis of the U.S. data, the National Longitudinal Study of Adolescent to Adult Health (Add Health), shows that among heterosexuals, working in a more female‐typical occupation is associated with lower levels of drug dependence symptoms for women and higher levels of depressive symptoms for men. Sexual minorities show a diverging pattern—working in a more female‐typical occupation is associated with worse mental health for sexual minority women and better mental health for sexual minority men.     

Job insecurity,employability, and mental health in the new era: A test of plausible influence mechanisms and temporal effects

Although job insecurity and employability have drawn much research attention, the plausible relationships between them and how they jointly influence mental health remain unclear in the literature. We draw upon JD-R and COR theories to test and contrast three plausible relationships between job insecurity and employability, using a longitudinal sample of 1216 employees over 18 years. We further expand tests of these theoretical positions by considering temporal dynamics, using dynamic structural equation models (DSEMs) for stronger mediation evidence and latent growth models (LGMs) to compare the effects of job insecurity and employability trends in predicting the trend of mental health. In general, findings showed that job insecurity mediated the relationship between employability and mental health, supporting the mediation hypothesis. We also found that employability moderated the relationship between job insecurity and mental health, supporting the moderation hypothesis, although the effect was weak. Results further suggested that the effect magnitudes of job insecurity and employability predicting mental health were significantly different. Specifically, job insecurity was a stronger predictor of mental health than employability across all 18 years; the trend of job insecurity also predicted the trend of mental health more strongly than the trend of employability. Taken together, this study not only advances theory precision but also methodological soundness of research on job insecurity, employability, and mental health, supporting the value of considering temporal factors in examining mental health effects of job insecurity and employability.     

Patterns of adverse childhood experiences and cardiovascular risk factors in U.S. adults

Adverse Childhood Experiences (ACEs) are associated with poor health yet, we know little about how distinct patterns of ACE types are associated with cardiovascular (cardiovascular (CVD)) risk factors. The current study 1) examined associations of latent ACE classes with modifiable CVD risk factors including high cholesterol, smoking, diabetes, hypertension, high triglycerides, physical inactivity, overweight/obesity, and lifetime depression; and 2) examined the impact of socioeconomic status-related (SES) factors on these relationships. Using a cross-sectional analysis of the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309) data, four latent classes of ACEs were previously identified: 1) low adversity, 2) primarily household dysfunction, 3) primarily maltreatment, and 4) multiple adversity types. We examined the association of these classes with CVD risk factors in adulthood and subsequently, the same model accounting for SES-related factors. Tobacco smoking, overweight/obesity, and lifetime depression were each associated with higher odds of being in classes 2, 3, and 4 than class 1, respectively. These relationships held after adjusting for SES-related factors. Class 4 was associated with the most CVD risk factors, including high triglycerides and high cholesterol after controlling for SES-related factors. The consistent associations between tobacco smoking, overweight/obesity, and lifetime depression with each adverse ACE profile, even after controlling for SES, suggest behavioural CVD prevention programs should target these CVD risk factors simultaneously.     

Resilience and Mental Health in Adult Survivors of Child Abuse Associated with the Institution of the Austrian Catholic Church

In recent years, reports of institutional abuse within the Catholic Church have emerged and research on the consequences on mental health is in its beginnings. In this study, we report findings on current mental health and resilience in a sample of adult survivors of institutional abuse (N = 185). We compared 3 groups of survivors that differed regarding their current mental health to investigate aspects of resilience, coping, and disclosure. The majority of the sample was male (76.2%), the mean age was 56.28 (SD = 9.46) years, and more than 50.0% of the sample was cohabiting/married. Most of the survivors reported severe mental health problems. Known protective factors (education, social support, age) were not associated with mental health in our sample. Our findings corroborate that institutional abuse has long‐term effects on mental health. We found that fewer emotional reactions during disclosure, task‐oriented coping, and optimism were associated with better mental health. The study was limited by a cross‐sectional design, but we conclude that the kind of institutional abuse reported is especially adverse, and thus typical protective factors for mental health do not apply. Future research should focus on intrapersonal factors and institutional dynamics to improve treatment for persons affected by institutional abuse.     

Resilience and Depression Influence Clinical Outcomes Following Primary Total Joint Arthroplasty

BackgroundResilience and depression may impact clinical outcomes following primary total joint arthroplasty (TJA). This study aimed to quantify baseline resilience and depression prevalence in patients undergoing primary TJA and evaluate their influence on patient-reported clinical outcomes.MethodsWe prospectively enrolled 98 patients undergoing primary TJA. Exclusion criteria included patients under 18 years of age, undergoing surgery for fracture, or who underwent additional surgery during the study period. Patients completed the Brief Resilience Scale to measure resilience, Patient Health Questionnaire-9 to measure depression, and Patient-Reported Outcomes Measurement Information System-10 to measure global physical and mental health preoperatively and 1 year postoperatively.ResultsPreoperatively, 22% and 15% of patients demonstrated major and mild depression, respectively. High resilience was identified in 34% of patients, normal resilience in 55%, and low resilience in 11%. Preoperative depression correlated with lower resilience, global physical health, and global mental health scores preoperatively as well as at 1 year after surgery (P < .001). Higher levels of preoperative resilience correlated with higher global physical and mental health scores preoperatively and at 1 year postoperatively (P < .001).ConclusionDepression symptoms are common among patients undergoing primary TJA and are associated with worse patient-reported outcomes. Patients with higher levels of resilience have higher global physical and mental health scores before and after TJA. Psychological traits and depression impact clinical outcomes following TJA.     

精神疾病患者未成年一级亲属病耻感与情绪行为问题的关系

目的 探讨精神疾病患者未成年一级亲属病耻感与情绪行为问题的关系,以及自我效能和心理弹性在病耻感与情绪行为问题关系中的中介效应.方法 选取山东省某精神卫生中心前来门诊就诊及住院的精神疾病患者未成年子女104人作为研究对象,采用Link贬低-歧视感知量表、一般自我效能量表（GSES）、心理弹性量表（RS）、长处和困难问卷（SDQ）进行调查.结果 精神疾病患者未成年一级亲属的情绪行为问题分别在性别、居住地、就读学校和是否独生子女上存在显著差异性（P＜0.05,P＜0.01）;精神疾病患者未成年一级亲属SDQ总分与病耻感呈显著正相关（P＜0.01）,与自我效能和心理弹性均呈显著负相关（均P＜0.01）;病耻感分别与心理弹性和自我效能均呈显著负相关（均P＜0.01）;心理弹性与自我效能呈显著正相关（P＜0.01）;自我效能和心理弹性在病耻感与情绪行为问题之间起到完全中介作用（P＜0.05,P＜0.01）.结论 感知到病耻感的精神疾病患者未成年一级亲属存在情绪行为问题,而自我效能和心理弹性在病耻感与精神疾病患者未成年一级亲属情绪行为问题关系中起完全中介作用.     

Effects of Adult Romantic Attachment and Social Support on Resilience and Depression in Individuals with Spinal Cord Injuries

Background:

Spinal cord injury (SCI) can cause psychological consequences that negatively affect quality of life. It is increasingly recognized that factors such as resilience and social support may produce a buffering effect and are associated with improved health outcomes. However the influence of adult attachment style on an individual’s ability to utilize social support after SCI has not been examined.

Objective:

The purpose of this study was to examine relationships between adult romantic attachment perceived social support depression and resilience in individuals with SCI. In addition we evaluated potential mediating effects of social support and adult attachment on resilience and depression.

Methods:

Participants included 106 adults with SCI undergoing inpatient rehabilitation. Individuals completed measures of adult attachment (avoidance and anxiety) social support resilience and depression. Path analysis was performed to assess for presence of mediation effects.

Results:

When accounting for the smaller sample size support was found for the model (comparative fit index = .927 chi square = 7.86 P = .01 β = -0.25 standard error [SE] = -2.93 P < .05). The mediating effect of social support on the association between attachment avoidance and resilience was the only hypothesized mediating effect found to be significant (β = -0.25 SE = -2.93 P < .05).

Conclusion:

Results suggest that individuals with SCI with higher levels of attachment avoidance have lower perceived social support which relates to lower perceived resilience. Assessing attachment patterns during inpatient rehabilitation may allow therapists to intervene to provide greater support.     

Anger Dimensions and Mental Health Following a Disaster: Distribution and Implications After a Major Bushfire

Anger is an important dimension of affect and a prominent feature of posttraumatic mental health, but it is commonly overlooked in postdisaster settings. We aimed to examine the distribution and implications of significant anger problems in the aftermath of a natural disaster, via analyses of Beyond Bushfires survey data from 736 residents of rural communities 5 years after the 2009 Black Saturday bushfires in Victoria, Australia. Assessments included the five‐item Dimensions of Anger Reaction (DAR‐5) scale along with measures of PTSD, depression, and significant mental illness, and indicators of life satisfaction, suicidality, hostile aggressive behavior, and violence exposure. The results indicated that approximately 10% of respondents from areas highly affected by the bushfires scored above the provisional cutoff criteria for significant anger problems on the DAR‐5, which was a more than 3‐fold increase, OR = 3.26, relative to respondents from areas of low‐to‐moderate bushfire impact. The rates were higher among women, younger participants, and those who were unemployed, and co‐occurred commonly, although not exclusively, with other postdisaster mental health problems. Anger problems were also associated with lower life satisfaction, β = ?.31, an 8‐fold increase in suicidal ideation, OR = 8.68, and a nearly 13‐fold increase in hostile aggressive behavior, OR = 12.98. There were associations with anger problems and violence exposure, which were reduced when controlling for covariates, including probable PTSD. The findings provide evidence indicating that anger is a significant issue for postdisaster mental health and should be considered routinely alongside other posttraumatic mental health issues.     

Resilience dimensions and mental health outcomes in bipolar disorder in a follow‐up study

The individual process of resilience has been related to positive outcomes in mental disorders. We aimed (a) to identify the resilience domains from the Resilience Questionnaire for Bipolar Disorder that are associated cross sectionally and longitudinally with mental health outcomes in bipolar disorder (BD) and (b) to explore cross‐lagged associations among resilience factors. A clinical adult sample of 125 patients diagnosed with BD (62.10% female, mean age = 46.13, SD = 10.89) gave their informed consent and completed a battery of disease‐specific tools on resilience, personal recovery, symptomatology, psychosocial functioning, and quality of life, at baseline and at follow‐up (n = 63, 58.10% female, mean age = 45.13, SD = 11.06, participation rate = 50.40%). Resilience domains of self‐management of BD, turning point, self‐care, and self‐confidence were significantly associated with mental health indicators at baseline. In addition, self‐confidence at baseline directly predicted an increase in personal recovery at follow‐up, and self‐confidence improvement mediated the relationship between interpersonal support and self‐care at baseline and personal recovery at follow‐up. These findings highlight that resilience domains are significantly associated with positive mental health outcomes in BD and that some predict personal recovery at follow‐up. Moreover, some resilience factors improve other resilience factors over time.     

The Long-Term Mental Health Consequences of Child Sexual Abuse: An Exploratory Study of the Impact of Multiple Traumas in a Sample of Women

The current study examined exposure to multiple traumas as mediators of the relationship between childhood sexual abuse and negative adult mental health outcomes. Participants were 174 women interviewed in the third wave of a longitudinal study of the consequences of child sexual abuse. Child sexual abuse victims reported a lifetime history of more exposure to various traumas and higher levels of mental health symptoms. Exposure to traumas in both childhood and adulthood other than child sexual abuse mediated the relationship between child sexual abuse and psychological distress in adulthood. There were also some significant direct effects for child sexual abuse on some outcome measures. Results point to the importance of understanding the interconnected nature of trauma exposure for some survivors.     

Quality of life,depression, and psychosocial mechanisms of suicide risk in prostate cancer

IntroductionProstate cancer (PCa) is the most common non-cutaneous cancer in men and is usually identified at a stage at which prolonged survival is expected. Therefore, strategies to address survivorship and promote well-being are crucial. This study’s aim was to better understand suicidal behavior in PCa patients by examining psychosocial mediators (i.e., depression, psychache, perceived burdensomeness [PB], thwarted belongingness [TB]) in the relationship between quality of life (PCa-QoL) and suicide risk.MethodsFour hundred and six men with PCa (Median age 69.35 years, standard deviation 7.79) completed an online survey on various psychosocial variables associated with suicide risk. A combined serial/parallel mediation model tested whether depression, in serial with both psychache and PB/TB, mediated the relationship between PCa-QoL and suicide risk.ResultsOver 14% of participants’ self-reports indicated clinically significant suicide risk. Poorer PCa-QoL was related to greater depression, which was related to both greater psychache and PB/TB, which was associated with greater suicide risk. The serial mediation effect of depression and psychache was significantly stronger than that of depression and PB/TB. PCa-QoL did not predict suicide risk through depression alone, showing that depressive symptoms affect suicide risk through psychache and PB/TB.ConclusionsGiven the alarming estimate of individuals at risk for suicide in this study, clinicians should consider patients with poorer PCa-QoL and elevated depression for psychosocial referral or management. Psychache (i.e., psychological pain) and PB/TB (i.e., poor social fit) may be important targets for reducing suicide risk intervention beyond the impact of depression alone.     

Psychosocial, socio-cultural, and environmental influences on mental health help-seeking among African-American men

The social determinants unique to African-American men's health contribute to limited access and utilization of health and mental health care services and can have a deleterious effect on their overall health and well-being. There is a need to examine the complex issues concerning African-American men's help-seeking behaviors relative to mental health concerns. Current research estimates that African-American men are approximately 30% more likely to report having a mental illness compared to non-Hispanic Whites and are less likely to receive proper diagnosis and treatment. There is an extensive body of research that supports the view that women are more likely to seek help for psychological problems than African-American men. This review explores the psychosocial, environmental and socio-cultural factors that influence mental health help-seeking behavior among African-American men and explains the urgency to engage various stakeholders to pursue effective behavioral strategies. Research literature concerning the relationships between social determinants of health and their mental health help-seeking behaviors is reviewed and discussed in this paper. The article illustrates the need for mental health providers and researchers to establish feasible, culturally competent prevention and intervention strategies to increase help seeking behavior among African-American men, thereby contributing to the reduction of mental health disparities.     

Adverse adult experiences and health outcomes: Racial and ethnic differences in a low-income sample

Extending research on adverse childhood experiences (ACEs), this study aimed to investigate whether the prevalence of and outcomes associated with adverse adult experiences vary among racial and ethnic subgroups. Survey data were collected from 1566 low-income women in Wisconsin using the Adult Experiences Survey (AES). Ten major adult adversities were assessed, including items that reference an intimate partner or household member (e.g., physical or emotional abuse, substance use) along with other social and economic stressors such as homelessness and discrimination. Adverse adult experiences were highly prevalent overall, but even more so among non-Hispanic Whites than their Black and Hispanic counterparts. The results reinforce prior research on ACEs in low-income populations. Lending further credence to these findings, tests of measurement invariance indicated that the AES demonstrated acceptable configural and scalar invariance across racial and ethnic groups. As expected, greater exposure to adult adversity was significantly related to poorer physical and mental health. These associations manifested cross-sectionally and longitudinally for observed and latent measures of adult adversity—even after controlling for ACEs. Associations between adult adversity and health were not moderated by race/ethnicity. In sum, adverse adult experiences were unequally distributed across racial/ethnic groups, but the consequences associated with adversity appeared to be evenly dispersed.