Conceptualizing Mental Health Through Bhutanese Refugee Lens: Findings from a Mixed Methods Study

Despite the rapidly growing need to understand mental health challenges faced by refugee subpopulations, there is a dearth of literature exploring mental health conceptualization through the unique refugee lens. Guided by historical trauma theory, we gathered data using a two-phase explanatory sequential mixed-methods study (quantitative: n?=?40; qualitative: n?=?6) in a Midwestern U.S. region to understand mental health conceptualization from the Bhutanese refugee perspective by examining the cultural meaning and perception of mental health, describing experiences of mental health problems, and examining cultural protective factors and coping strategies. We argue that recognition of refugees’ conceptualization of mental health and identification of cultural protective factors is paramount to healing. Findings emphasize the need to understand historical and cultural perspectives in cross-cultural contexts for the development and implementation of culturally responsive services. Our study also contributes to emerging knowledge on methodological rigor in research among understudied, hard-to-reach, small populations.

     

The FRIENDS Emotional Health Programme: Initial Findings from a School-Based Project

Emotional disorders in children are common and although effective interventions are available comparatively few receive specialist help. School nurses were trained to deliver an evidence-based emotional health cognitive behaviour therapy programme, FRIENDS, to 106 non-referred children aged 9–10 attending three schools. Levels of anxiety and self-esteem were stable in the 6-month period before FRIENDS. Three months after completing FRIENDS, anxiety had significantly decreased and self-esteem increased. Children with the most severe emotional problems benefited from the programme. The value of delivering standardised evidence based programmes in schools by school nurses is discussed and the need for further research highlighted.     

Supporting Veterans,Caregivers, and Providers in Rural Regions With Tele-Geriatric Psychiatry Consultation: A Mixed Methods Pilot Study

ObjectivesCross-facility tele-geriatric psychiatry consultation is a promising model for providing specialty services to regions lacking sufficient geriatric psychiatry expertise. This evaluation focused on assessing the feasibility and acceptability of a consultation program developed by a geriatric psychiatrist in a Veterans Health Administration regional telehealth hub.DesignConcurrent, mixed methods program evaluation.SettingA region served by a VA health care system telehealth hub.ParticipantsPatients with at least 1 geriatric mental health encounter with a geriatric psychiatrist consultant during a 1 year-period; referring providers.InterventionVirtual psychiatric evaluation of Veterans with time-limited follow-up and e-consultation with providers.MeasurementsInterviews with consultant, medical record data, and referring provider surveys.ResultsThree hundred fifteen Veterans (M = 76.0 ± 9.64 years; 40% rural-dwelling) had 666 encounters (M = 2.11 ± 1.78) with most occurring via clinical video telehealth (n = 443; 67.6%), e-consultation (n = 99; 15.1%), or video to home (n = 95; 14.5%). Most encounters were related to neurocognitive disorders, depressive disorders, trauma-related disorders, or serious mental illness. Referring providers (N = 58) highly recommended the program, reported high satisfaction, followed through with recommendations, and believed that this program increased access to geriatric psychiatry.ConclusionsThis single program was shown to be feasible, acceptable, and valued by the referring providers. The findings highlighted the complex presentations of Veterans referred, and the current unmet need of providers of such Veterans, providing impetus for wider implementation.     

Behavioral Health Provider Attitudes and Beliefs about Sexuality and Intimacy: Findings from a Mixed Method Design

Recovery-oriented services overlook a crucial health domain for persons with severe mental illnesses (SMI): sexuality and intimacy. Though this aspect of social recovery correlates with improved life quality and treatment outcomes, behavioral health (BH) providers avoid such topics. The study’s purpose was to obtain an updated snapshot of their attitudes and beliefs about sexuality and intimacy communication. Utilizing a community advisory board, we adapted the Sexual Attitudes and Beliefs Survey (SABS) and distributed it via survey link to a national listserv. We used independent samples t-tests to examine differences on SABS mean scores by gender, age group, educational attainment, and previous training on sexuality and intimacy. We asked open-ended questions and coded responses using content analysis. Participants with more education and previous exposure to training on sexuality and intimacy were more likely to hold open views on communication. Findings offer directions for addressing this neglected aspect of recovery.

     

The State of School Social Work: Findings from the National School Social Work Survey

School social work is a large and growing subspecialty in social work practice; however, little is known about present school social work practice from a national perspective. The National School Social Work Survey (n = 1,639) represents the first data in over ten years to describe the diverse practice contexts and interventions employed by school social workers. The survey also seeks to better understand school social work practice in light of the significant educational reforms of the past decade that are increasingly shaping student experiences. Findings from this survey indicate that the characteristics of school social workers, the context in which they practice, and their practice choices remain largely unchanged over the past 10 years. Implications for future research, policy, and practice are discussed based on these findings.     

Cognitive Control: Social Evolution and Emotional Regulation

This commentary argues that theories of cognitive control risk being incomplete unless they incorporate social/emotional factors. Social factors very likely played a critical role in the evolution of human cognitive control abilities, and emotional states are the primary regulatory mechanisms of cognitive control.     

Mania,Hypomania, and Suicidality: Findings from a Prospective Community Study

ABSTRACT

We examined prospectively whether mania and hypomania are associated with an elevated risk for suicidality in a community sample of adolescents and young adults. Baseline and four-year follow-up data were used from the Early-Developmental-Stages-of-Psychopathology (EDSP) Study, a prospective longitudinal study of adolescents and young adults in Munich. Suicidal tendencies (ideation/attempts), mania, and hypomania were assessed using the standardized Munich-Composite-International-Diagnostic-Interview. At baseline, mania/hypomania was associated to a different degree with suicidality (Odds ratios [OR] range from 1.9 to 13.7). In the prospective analyses, the risk for subsequent incident suicidal ideation was increased in the presence of prior mania (38.0% vs. 14.1%; OR = 4.4; 95% CI = 1.4–13.5). No associations could be found between prior mania/hypo-mania and incident suicide attempts. The prospective analyses revealed a remarkable relationship between preexisting mania and increased risk for subsequent suicidal ideation.     

Disaster Mental Health Epidemiology: Methodological Review and Interpretation of Research Findings

Worldwide, disasters are increasing in frequency and severity. Mental health consequences of disasters are extensive, and knowledge of anticipated mental health effects is needed for effective disaster response. Difficulties inherent in conducting disaster research have limited the understanding of research findings. This article presents and interprets disaster mental health research findings in the context of research methods. A brief history of the disaster mental health research field is provided, and the presentation of findings is ordered into topical areas of disaster mental health consequences and timing and prediction of mental health outcomes. Results of different studies varied greatly by several main characteristics of research methods, especially methods of psychiatric assessment, sampling and exposure group determination, and consideration of confounding variables. In conclusion, many complexities in conducting disaster mental health research have limited the understanding and interpretation of available knowledge needed to inform efforts to plan and carry out effective mental health responses to disasters. Thoughtful interpretation of findings in the context of research design and methods is vital to accurate understanding of the types, prevalence, and predictors of anticipated mental health effects of disasters. A wealth of knowledge from disaster mental health research has accumulated in recent decades, but more research is still needed to resolve inconsistent findings through methodological refinements.     

Developing Clinically Suitable Measures of Social Cognition for Children: Initial Findings from a Normative Sample

Our understanding of children's social competence has increased tremendously over the past two decades. There is increasing evidence to suggest that social–cognitive impairments are not restricted to children on the autistic spectrum, but rather may be associated with a host of developmental and acquired neurological conditions including learning disabilities, attention deficit disorder, traumatic brain injury, and stroke. Although many investigators have begun to bridge the gap between clinical practice and research by applying experimental tasks to clinical populations, few tools are available for the clinical evaluation of social competence, particularly in children. This study marks a series of first steps in the development of measures suitable for the assessment of children between 6 and 12 years of age. The results of the study provide data for a number of experimental tasks that have been adapted with clinical practice in mind. A discussion of the developmental progressions and the relationships among the measures is also included.     

Disaster Victim Identification: Psychological Distress and Posttraumatic Stress in Dentists After the 2011 Fukushima Disaster

Objective: To evaluate the correlates of psychological responses in dentists who conducted disaster victim identification (DVI) in Fukushima following the 2011 earthquake/tsunami/nuclear disaster. Method: Self-report questionnaires were administered to 49 male dentists six to nine months after the disaster. Psychological distress and posttraumatic stress were measured using the General Health Questionnaire–30 (GHQ-30) and Impact of Event Scale–Revised (IES-R), respectively. Independent variables included sociodemographic characteristics, participant disaster exposures, DVI-related exposures, and fear of radiation exposure during DVI. Hierarchical multiple regression analysis was performed to examine independent-dependent variable relations. Results: Thirty-eight participants (77.6%) had examined ≥ 40 corpses, 20 (40.8%) reported ≥ 4 corpse-related exposures, and six (12.2%) reported ≥ 5 gruesome corpse exposures. Mean (SD) GHQ-30 and IES-R scores were 5.08 (5.31) and 9.90 (10.1), respectively. Higher levels of psychological distress were associated with younger age (adjusted β = ?0.29), extensive property loss (β = 0.34), and anxiety for the future (β = 0.33). Higher levels of posttraumatic stress were associated with extensive property loss (adjusted R² = 17.7%, β = 0.30). Neither outcome was associated with DVI-related exposures or fear of radiation exposure during DVI (p < 0.05). Conclusions: Dentists’ psychological burden was associated with disaster, but not DVI, exposures.     

Comparing Stakeholders’ Knowledge and Beliefs About Supporting Students’ Social,Emotional, and Behavioral Health in Schools

Schools can play a significant role in promoting timely access to mental health services by utilizing proactive approaches to identifying and supporting st     

Supporting Parents Who Have Youth with Emotional Disturbances Through a Parent-to-Parent Support Program: A Proof of Concept Study Using Random Assignment

Poor outcomes for youth who have emotional disturbances (ED), especially for those youth who are placed in special education programs, are well documented. Parent Connectors is a parent-to-parent support program delivered through weekly telephone calls to families of youth with ED in special education programs, with the aim of increasing the engagement of parents in their child’s education and treatment and improving the academic and emotional functioning of the child. Findings from a proof of concept study using random assignment of participants yielded encouraging support for the clinical efficacy of the intervention. Results demonstrated enhanced outcomes for parents who were highly strained at the beginning of the study. Implications for future research in the area of parent support are provided.     

Neuropsychological Findings in a Case of Punding Before and After Cessation of Pramipexole

Clinical neuropsychologists are well trained to recognize neurological and psychiatric conditions that impact behavior, but tend to have less familiarity with iatrogenic consequences of various pharmacological treatments. One such consequence is the development of an impulse control disorder (ICD), which can result from treatment with dopamine agonists. Knowledge of ICDs is important because they can mimic obsessive-compulsive disorder, mania, or the behavioral variant of frontotemporal dementia. The current case examines a patient who developed punding, which is a type of ICD characterized by repetitive behavior, as a result of treatment with pramipexole. Neuropsychological testing was conducted before and after cessation of pramipexole, and showed that the removal of the medication was consistent with improvement in frontal-subcortical-mediated cognitive functions. Findings suggest that neuropsychologists should be familiar with the symptoms of ICDs and incorporate such knowledge into their case conceptualizations.     

COPD and Depressive Symptoms: Findings from the Guangzhou Biobank Cohort Study

Background

Chronic obstructive pulmonary disease (COPD) co-exists with depression, but important questions remain about the determinants of this association.

Purpose

We examined the association of depressive symptoms with three aspects of COPD: self-reports of physician-diagnosed COPD, chronic respiratory symptoms, and airway obstruction.

Methods

We used data from the Guangzhou Biobank Cohort Study (n?=?7,995). Airway obstruction was assessed by spirometry. A score ??4 on the 15-item Geriatric Depression Scale was used as a cutoff for depressive symptoms.

Results

Self-reported COPD was positively associated with depressive symptoms but airway obstruction was not. Compared to those free of both respiratory symptoms and airway obstruction those reporting respiratory symptoms were more likely to have depressive symptoms regardless of whether they had obstruction or not.

Conclusions

In this Chinese population, a self-reported physician diagnosis of COPD and symptom perception, but not airway obstruction, appeared as main determinants of depressive symptoms.     

The Impact of Transitions,a Mental Health Literacy Intervention With Embedded Life Skills for Postsecondary Students: Preliminary Findings From a Naturalistic Cohort Study

ObjectiveMental illness is a common medical condition to onset during adolescence. Young people who leave for postsecondary life are at an especially challenging period of lifetime when many will leave home and familiar environments for prolonged periods of time. These new circumstances may put young people at risk of developing mental health problems or disorders or exacerbate existing mental disorders. Alternatively, some young people may misinterpret the normal negative emotional states occurring as a result of these new challenges as a mental disorder requiring professional intervention. We conducted a quasiexperimental cohort study to investigate the effectiveness of a mental health literacy intervention Transitions with blended life skills to address these challenges for first-year postsecondary students.MethodsStudents (n = 2,397) from five Canadian postsecondary institutions were assigned to the intervention or the control group and were administered a survey at baseline, postintervention, and at 2-month follow-up (September 2017 to February 2018). We applied generalized linear mixed effects (PROC Mixed procedure) to test the between-group difference in the post—pre/follow-up—pre and to determine the predicted least-square mean values.ResultsThe findings showed that students who were exposed to the Transitions intervention significantly improved their mental health knowledge, decreased stigma against mental illness, improved help-seeking attitudes and behaviours, and decreased perceived stress when compared to students who had not been exposed to the intervention. However, we did not identify significant changes in general health. This may be due to the relatively short follow-up time (2 months) to determine participants’ general health status.ConclusionsTransitions delivered to first-year postsecondary students may be a beneficial intervention to help young people adjust to their new postsecondary life and improve their mental health.