Social skills group training (SSGT) is widely used for intellectually able children and adolescents with autism spectrum disorder (ASD). Previous studies indicate small to moderate effects on social communication capacities. The duration of most available programs is relatively short, and extended training might lead to further improvement. This randomized controlled trial compared an extended 24-week version of the SSGT program KONTAKT with standard care. The weekly sessions gradually shifted in content from acquisition of new skills to real-world application of the acquired skills. A total of 50 participants with ASD (15 females; 35 males) aged 8–17 years were included. The study was conducted at two child and adolescent psychiatry outpatient units in Sweden. The primary outcome was the Social Responsiveness Scale–Second Edition (SRS-2) rated by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and at 3-months follow-up. Parent-rated SRS-2 scores indicated large effects posttreatment [− 19.2; 95% CI − 29.9 to − 8.5; p < .001, effect size (ES) = 0.76], which were maintained at follow-up (− 20.7; 95% CI − 31.7 to − 9.7; p < .0001, ES = 0.82). These estimates indicate substantially larger improvement than previously reported for shorter SSGT. However, the effects on teacher-rated SRS-2 and most secondary outcomes did not reach statistical significance. Our results suggest added benefits of extended SSGT training, implying that service providers might reach better results by optimizing the delivery of SSGT.
相似文献Social support is an important correlate of health behaviors and outcomes. Studies suggest that veterans have lower social support than civilians, but interpretation is hindered by methodological limitations. Furthermore, little is known about how sex influences veteran–civilian differences. Therefore, we examined veteran–civilian differences in several dimensions of social support and whether differences varied by sex.
MethodsWe performed a cross-sectional analysis of the 2012–2013 National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative sample of 34,331 respondents (male veterans = 2569; female veterans = 356). We examined veteran–civilian differences in functional and structural social support using linear regression and variation by sex with interactions. We adjusted for socio-demographics, childhood experiences, and physical and mental health.
ResultsCompared to civilians, veterans had lower social network diversity scores (difference [diff] = − 0.13, 95% confidence interval [CI] − 0.23, − 0.03). Among women but not men, veterans had smaller social network size (diff = − 2.27, 95% CI − 3.81, − 0.73) than civilians, attributable to differences in religious groups, volunteers, and coworkers. Among men, veterans had lower social network diversity scores than civilians (diff = − 0.13, 95% CI − 0.23, − 0.03); while among women, the difference was similar but did not reach statistical significance (diff = − 0.13, 95% CI − 0.23, 0.09). There was limited evidence of functional social support differences.
ConclusionAfter accounting for factors that influence military entry and social support, veterans reported significantly lower structural social support, which may be attributable to reintegration challenges and geographic mobility. Findings suggest that veterans could benefit from programs to enhance structural social support and improve health outcomes, with female veterans potentially in greatest need.
相似文献To ensure the mental health of the otolaryngology healthcare workers in the fight against coronavirus disease 2019 (COVID-19), it is important to know their mental status and to identify possible risk factors. In this study, we investigated the risk factors for the anxiety in the otolaryngology healthcare workers in Hubei province under the COVID-19 epidemic.
MethodsThe otolaryngology healthcare workers in Hubei Province were surveyed using an online questionnaire in which anxiety was measured against the Zung Self-rating Anxiety Scale. Univariate and multivariate logistic regression analyses were used to evaluate the risk factors of anxiety.
ResultsA total of 449 otolaryngology healthcare workers participated in the study. Of all the participants, 131 (29.18%) had anxiety symptoms. Compared with doctors, nurses were at a higher risk for anxiety (OR = 2.162, 95% CI 1.311–3.566). Participants who often suspected self-infection (OR = 4.239, 95% CI 1.647–10.909) or family member infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (OR = 4.485, 95% CI 1.511–13.313) were more likely to develop anxiety than those who never. The subjects who had colleagues diagnosed with COVID-19 were more vulnerable to anxiety (OR = 2.014, 95% CI 1.205–3.366). Respondents working in infectious isolation wards had a 3.522-fold increased risk of anxiety compared to those on leave (OR = 3.522, 95% CI 1.634–7.593).
ConclusionSome otolaryngology healthcare workers in Hubei province experienced anxiety during the epidemic, but most of them did not receive treatment. The healthcare providers themselves should be informed about and aware of their own mental health, and should be given support as appropriate.
Trial registration number and date of registrationChinese Clinical Trial Registry: ChiCTR2000030768, 2020/3/14.
相似文献Although suicide rates of prison populations and incidence factors have been reported for high-income countries, data from low- and middle-income regions are lacking. The purpose of the study was to estimate suicide rates among prison populations in South America, to examine prison-related factors, and to compare suicide rates between prison and general populations.
MethodsIn this observational study, we collected the numbers of suicides in prison, rates of prison occupancy, and incarceration rates from primary sources in South America between 2000 and 2017. We compared suicide rates among prisoners with incidence rates in the general populations by calculating incidence rate ratios. We assessed the effect of gender, year, incarceration rates and occupancy on suicide rates in the prison populations using regression analyses.
ResultsThere were 1324 suicides reported during 4,437,591 person years of imprisonment between 2000 and 2017 in 10 South American countries. The mean suicide rate was 40 (95% CI 16–65) per 100,000 person years for male and female genders combined. The pooled incidence rate ratio of suicide between prison and general populations was 3.9 (95% CI 3.1–5.1) for both genders combined, 2.4 (95% CI 1.9–3.1) for men and a higher ratio in women (13.5, 95% CI 6.9–26.9). High occupancies of prisons were associated with lower incidence of suicide (β = − 58, 95% CI − 108.5 to − 7.1).
ConclusionsSuicides during imprisonment in South America are an important public health problem. Suicide prevention strategies need to target prison populations.
相似文献This study aimed at determining to what extent sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorder diagnosis in British Columbia (BC), Canada, using a population-based survey.
MethodsThis analysis was based on the cross-sectional 2013–2014 Canadian Community Health Survey. The sample was restricted to respondents in BC with valid responses to the survey items considered. A multivariable logistic model, where the behavioral HIV risk score exposure was nested into the sexual minority status modifier, estimated the odds of having a prevalent mood or an anxiety disorder. The behavioral HIV risk score (0, 1, 2, ≥ 3) included the following five measures: (1) age at first intercourse < 14 years, (2) condom use during last intercourse, (3) history of sexually transmitted infections, (5) number of sexual partners in the past 12 months (< 4, ≥ 4), and substance use in the past 12 months.
ResultsOf the weighted sample (2,521,252), 97% (95% confidence interval (CI) 97–98) were heterosexual, while 3% (95% CI 2–3) were lesbian, gay, and bisexual (LGB). The prevalence of a mood or anxiety disorder diagnosis was 12% (95% CI 11–13). For every 1-level increment in the behavioral HIV risk score, the adjusted odds ratio of having a prevalent mood or anxiety disorder diagnosis was 1.29 (95% CI 1.03–1.54) for heterosexual respondents and 2.37 (95% CI 1.84–2.90) for LGB respondents.
ConclusionSexual minority status modified the relationship between HIV risk behavior and prevalent mood or anxiety disorders, with a stronger association among LGB respondents. Healthcare providers should prioritize integrated care that addresses the intersectionality between sexual risk, substance use, and mood or anxiety disorders.
相似文献In India, antenatal anxiety prevalence estimates range from 6 to 48%. Social support is strongly associated with mental wellbeing, yet most studies have examined the impact of support from partners and family members rather than peers, community members, or health care providers. This study explores the supportive role of Accredited Social Health Activists (ASHA) contacts for antenatal anxiety.
MethodsData were analyzed from the Saving Children, Improving Lives project, a quasi-experimental study conducted among rural, pregnant women in India. Regression models were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals for the relationship frequency of ASHA contacts and antenatal anxiety. Antenatal anxiety was measured using a subscale of the Edinburgh Postnatal Depression Scale.
ResultsThe sample consisted of 480 pregnant women. Reported antenatal anxiety prevalence was 27% (95% CI 23%, 31%). Participants who were more frequently visited by ASHAs at home (aPR: 0.90; 95% CI 0.76, 0.98) and more frequently accompanied by ASHAs to their antenatal care visits (aPR: 0.86, 95% CI 0.78, 0.95) were less likely to report antenatal anxiety. ASHA home visits were protective for the most vulnerable women (primigravida and those experiencing domestic violence) and ASHA accompaniment to antenatal care visits was equally protective for all women.
ConclusionsASHAs are valued for their contribution towards maternal health education and linking women of reproductive age to healthcare services. Our findings additionally suggest the important role ASHAs play in providing social support to pregnant women, particularly those who are most vulnerable to experiencing antenatal anxiety.
相似文献Depression is a major contributor to the global burden of disease. The extent to which marital communication may influence depression in contexts with little mental health support is unknown.
MethodsWe conducted a whole-population study of married adult residents of eight villages in a rural region of southwestern Uganda. Depression symptom severity was measured using a modified version of the Hopkins Symptom Checklist for Depression, with > 1.75 classified as a positive screen for probable depression. Respondents were asked to report about ease of marital communication (‘never easy’, ‘easy once in a while’, ‘easy most of the time’ or ‘always easy’). Sex-stratified, multivariable Poisson regression models were fit to estimate the association between depression symptom severity and marital communication.
ResultsAmong 492 female and 447 male participants (response rate = 96%), 23 women and 5 men reported communication as ‘never easy’ and 154 women and 72 men reported it as ‘easy once in a while’. Reporting communication as ‘never easy’ was associated with an increased risk of probable depression among women (adjusted relative risk [ARR], 2.06; 95% confidence interval [CI], 1.08–3.93, p = 0.028) and among men (ARR, 7.10; 95% CI 1.70–29.56, p = 0.007).
ConclusionIn this whole-population study of married adults in rural Uganda, difficulty of marital communication was associated with depression symptom severity. Additional research is needed to assess whether communication training facilitated by local leaders or incorporated into couples-based services might be a novel pathway to address mental health burden.
相似文献Research shows that the prevalence of psychiatric problems is higher in ethnic minority youth compared to native youth. This school-based screening study of early adolescents’ mental health in the Netherlands examined differences in prevalence of psychotic experiences in ethnic minority youth compared to their Dutch peers. Moreover, we investigated the association between psychotic experiences, ethnic identity, and perceived discrimination.
MethodsA cohort of 1194 ethnic majority and minority adolescents (mean age 13.72, SD 0.63) filled-out questionnaires on psychotic experiences (including delusional and hallucinatory experiences), perceived group and personal discrimination, and ethnic identity.
ResultsApart from lower levels of hallucinatory experiences in Turkish–Dutch adolescents, prevalence of psychotic experiences did not differ between ethnic minority and majority adolescents. Perceived personal discrimination was associated with the presence of psychotic experiences (including delusional and hallucinatory experiences) (OR 2.30, 95% CI 1.22–4.34). This association was stronger for delusional experiences (OR 2.94, 95% CI 1.43–6.06) than for hallucinatory experiences (OR 1.65, 95% CI 0.73–3.72). No significant associations were found between perceived group discrimination and psychotic experiences. A weak ethnic identity was associated with higher risk for reporting psychotic experiences (OR 2.04, 95% CI 1.14–3.66), particularly hallucinatory experiences (OR 3.15, 95% CI 1.54–6.44). When looking at specific ethnic identity categories, marginalization, compared to separation, was associated with a threefold risk for reporting psychotic experiences (OR 3.26, 95% CI 1.33–8.03). Both marginalisation (OR 3.17, 95% CI 1.04–9.63) and assimilation (OR 3.25, 95% CI 1.30–8.13) were associated with a higher risk for hallucinatory experiences.
ConclusionsThese results underline the protective effect of ethnic identity against mental health problems. Future research should focus on interventions that focus on strengthen social identity.
相似文献Method: In a cross-sectional study, we evaluated 217 hospitalized elderly patients with an age range 65–95 (mean 77.9) years. Perceived health was rated on a four-point scale. Physical health was measured with the Charlson index; functional status was rated using the Lawton and Brody's scale for self-maintaining and instrumental activities of daily living; and, anxiety and depression were rated using the Hospital Anxiety and Depression scale. Finally, the 13-item version of the SOC scale was used to assess coping, and cognitive state was assessed using the Mini-mental State Examination.
Results: In all, 40% of the patients reported good perceived health. In an adjusted logistic regression analysis, the main outcome good perceived health was associated with increasing age: odds ratio (OR) 1.06 (95% CI 1.01–1.11); good physical health: OR 2.49 (95% CI 1.22–5.07); and, medium high and high SOC: OR 2.48 (95% CI 1.20–5.13), and OR 2.43 (95% CI 1.11–5.28), respectively. Explained variance was 22.2%.
Conclusion: Good coping resources and low severity of co-morbid disorders are the two most important factors that explain why elderly inpatients rate their health as good. Since coping may be equally important as poor physical health for perception of health, coping should be recognized and measured in clinical practice. 相似文献
This study is aimed to investigate the mental health status of COVID-19 survivors 1 year after discharge from hospital and reveal the related risk factors.
MethodsFrom April 11 to May 11, 2021, 566 COVID-19 survivors in Huanggang city were recruited through their primary doctors. A total of 535 participants (94.5%) admitted to participate in the survey and completed the questionnaires. Five scales were applied including 7-Items Generalized Anxiety Disorder Scale, Patient Health Questionnaire-9, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and Fatigue Scale-14. The chi-square and the Fisher’s exact test were used to evaluate the classification data, multivariate logistic regression was used to explore the related factors of sleep quality, fatigue, anxiety, depression, and post-traumatic stress disorder (PTSD).
ResultsOne year after being discharged, of the 535 COVID-19 survivors, 252 (47.1%) had poor sleep quality; 157 (29.3%) had the symptoms of fatigue; 84 (15.7%),112 (20.9%), and 130 (24.3%) suffered from symptoms of anxiety, depression, and PTSD, respectively. The logistic regression analysis showed that history of chronic disease was risk factor for poor sleep quality (OR 2.501; 95% CI, 1.618–3.866), fatigue (OR 3.284; 95% CI 2.143–5.033), PTSD (OR 2.323; 95% CI 1.431–3.773) and depression (OR 1.950; 95% CI 1.106–3.436) in COVID-19 survivors. Smoking contributed to the poor sleep quality (OR 2.005; 95% CI 1.044–3.850), anxiety (OR 4.491; 95% CI 2.276–8.861) and depression (OR 5.459; 95% CI 2.651–11.239) in survivors. Drinking influenced fatigue (OR 2.783; 95% CI 1.331–5.819) and PTSD (OR 4.419; 95% CI 1.990–9.814) in survivors. Compared with college-educated survivors, survivors with high school education were at higher risk for poor sleep quality (OR 1.828; 95% CI 1.050–3.181) and PTSD (OR 2.521; 95% CI 1.316–4.830), and survivors with junior high school education were at higher risk for PTSD (OR 2.078; 95% CI 1.039–4.155). Compared with overweight survivors (BMI ≥ 23.0), survivors with normal BMI (18.5–22.9) (OR 0.600; 95% CI 0.405–0.889) were at lower risk for fatigue. While being housewife (OR 0.390; 95% CI 0.189–0.803) was protective factor for fatigue and having more family members was protective factor for PTSD (OR 0.404 95% CI 0.250–0.653) in survivors.
ConclusionsOne year after infection, poor sleep quality, fatigue, anxiety, depression, and PTSD, still existed in a relatively high proportion of COVID-19 survivors. Chronic disease history was an independent risk factor for poor sleep quality, fatigue, depression, and PTSD. Participants with low education levels were more likely to have mental problems than the others. We should focus on the long-term psychological impact of COVID-19 on survivors, and the government should apply appropriate mental health services to offer psychiatric support.
相似文献The purpose of this study was to determine the association of individual-level and community-level parental social capital with childhood behavior problems using population-based longitudinal data in Japan.
MethodsWe analyzed data from a population-based longitudinal survey study which followed first-grade elementary school children (6–7 years old) in Adachi City, Tokyo, Japan. At baseline, the parents of first-grade students from all 69 elementary schools in Adachi City were asked to respond to a questionnaire assessing behavior problems and prosocial behavior (using the Strengths and Difficulties Questionnaire) and parental social capital in the community (N = 5494). Data on follow-up questionnaires on behavior problems were collected when children were second grade. Among both surveys, 3656 parents returned valid responses. The association between individual-level and community-level parental social capital and children's behavior problems were analyzed using multilevel analyses adjusting for covariates.
ResultsCommunity-level social capital was positively associated with prosocial behaviors, but not for total difficulties, after adjustment for covariates (coefficient = 0.19, 95% CI 0.03 to 0.36). Individual-level parental social capital was also positively associated with prosocial behaviors (coefficient = 0.27, 95% CI 0.12 to 0.41) and negatively associated with total difficulties (coefficient = − 0.54, 95% CI − 0.89 to − 0.19).
ConclusionsThis study showed that greater community-level social capital can benefit children with increased prosocial behaviors. Individual-level parental social capital can be protective of youth by increasing prosocial behaviors and reducing difficult behaviors. Boosting both community and individual social capital can be a promising means to enhance children’s well-being.
相似文献We aimed to estimate the structure of internalizing and externalizing symptoms and potential time dynamics in their association. This is understudied among adolescents, despite increasing internalizing and decreasing externalizing symptoms in recent years.
MethodsWe analyzed data from US Monitoring the Future cross-sectional surveys (1991–2018) representative of school-attending adolescents (N = 304,542). Exploratory factor analysis using maximum likelihood estimation method and promax rotation resulted in a two-factor solution (factor correlation r = 0.24) that differentiated eight internalizing and seven conduct-related externalizing symptoms. Time-varying effect modification linear regression models estimated the association between standardized internalizing and externalizing symptoms factor scores over time overall and by gender.
ResultsIn 2012, trends in average factor scores diverged for internalizing and externalizing factors. The average standardized internalizing factor score increased from − 0.03 in 2012 to 0.06 in 2013 and the average externalizing factor score decreased from − 0.06 in 2011 to − 0.13 in 2012. We found that for every one-unit increase in standardized internalizing factor score, standardized externalizing factor score increased by 0.224 units in 2010 (95% CI: 0.215, 0.233); the magnitude of this increase was 22.3% lower in 2018 (i.e., 0.174 units; 95% CI: 0.160, 0.188). Decoupling of internalizing and externalizing symptoms began earlier among boys (~ 1995) than among girls (~ 2010).
ConclusionThe decoupling of internalizing and externalizing symptoms among adolescents suggests that changes in the prevalence of shared risk factors for adolescent psychiatric symptoms affect these dimensions in opposing directions, raising the importance of considering symptoms and their risk factors together in prevention and intervention efforts.
相似文献