新乡市大学生心理健康与紧张性生活事件及应付方式的关系

目的　探讨紧张性生活事件、应付方式与大学生心理健康之间的关系 ,为进一步科学地传授心理健康知识提供依据。方法　以新乡市 3所高校 6 0 7名一年级大学生为研究对象 ,用症状自评量表 (SCL - 90 )、紧张性生活事件评定量表、简易应付方式问卷 ,分别评定其心理健康水平、心理压力和应对方式。结果　 6 0 7名大学生有心理症状 ,占 14 .99% ;心理问题组紧张性生活事件的压力明显高于对照组(P <0 .0 5) ;心理问题组消极应对因子分高于对照组 (P <0 .0 5) ;积极因子两组无明显差异 (P >0 .0 5) ;心理问题组SCL - 90总分和消极应对因子分呈正相关 ,与积极应对因子分呈负相关 (P <0 .0 1)。结论　紧张性生活事件和应对方式都是影响大学生心理健康的重要因素。     

Associations Between Stressful Events and Self-Reported Mental Health Problems Among Non-Western Immigrants in Denmark

The aim of the present paper is to investigate the relationships of stressful events with self-reported mental health problems in the general population, comparing non-western immigrants with Danish nationals. 11.500 individuals aged 18–64 years from eight ethnic groups were invited to participate in a bilingual telephone survey on health among ethnic minorities in Denmark in 2007. Overall response rate is 52.1%. 3.997 individuals were selected for the present study. Self-reported mental health problems is twice as high among immigrants from Ex-Yugoslavia (24.6%), Iraq (30.2%) Iran (20.5%), Lebanon (27.2%) and Pakistan (19.9%), as among Danish nationals (9.7%) χ² (7, n = 3.997) = 21.57, P > 0.00. Non-western immigrants report twelve out of thirteen types of stressful events more frequently compared to Danish nationals. The most frequently reported stressful event among non-western immigrants is ‘personal disease’. Immigrants perceive the perils of daily life as more stressful in comparison with host nationals probably because of the additional challenges of adjusting to a new environment.     

Stressful Life Events,Culture, and Violence

This study explored the contributions of stressful life events and their interactions with social support and cultural factors in predicting serious violence among American adolescent immigrants of Chinese and Southeast Asian origins. Youth differed in their exposure to stressors and how they responded to them. Cambodian and Laotian youth reported the highest levels of stressors, except for emotional abuse. Only physical abuse was an independent predictor of serious violence for all groups, except Chinese. Perceived social support buffered the effects of some stressors, whereas increased levels of acculturation, intergenerational/intercultural conflict, and individualism placed youth at increased risk for serious violence. The results suggest that the moderating effects of culture and social support need to be considered when examining the association between life stressors and serious violence for Chinese and Southeast Asian youth.     

Mental Health Problems in Separated Refugee Adolescents

PurposeAs migration and separation from parents are widely recognized as important risk factors for the mental health of adolescents, this study aims to investigate mental health problems in refugee adolescents separated from their parents compared to their accompanied peers, all living in Belgium.MethodsOne thousand two hundred ninety-four adolescents—10% of them refugee adolescents separated from both parents—completed three self-report questionnaires (Hopkins Symptoms Checklist-37A, Stressful Life Events, and Reaction of Adolescents to Traumatic Stress) on the prevalence of traumatic experiences, anxiety, and depression symptoms, externalizing problems, and posttraumatic stress.ResultsRefugee adolescents separated from both parents experienced the highest number of traumatic events compared to accompanied refugee adolescents. Risk factors influencing the development of serious mental health problems (anxiety, depression, and posttraumatic stress) are separation from parents, high number of traumatizing events experienced, and gender. Despite the fact that refugee adolescents living only with their mother experienced more traumatizing events compared to adolescents living with both parents, they have fewer mental health problems than refugee adolescents living with their father.ConclusionsThis study confirms the importance of the availability of parents to adolescents who have to deal with migration experiences, because separated refugee adolescents are at higher risk to experience multiple traumatic experiences and to develop severe mental health problems. Reception and care structures should provide more adequate preventive and curative interventions to these at-risk groups, and government policies should consider these adolescents primarily as “minors” rather than just “refugees.”     

Utilization of Mental Health Services Among Adolescents in Community-Based Substance Abuse Outpatient Clinics

This study examined the rates and correlates of self-reported receipt for mental health services among 1,190 adolescents, aged 12–19, who were admitted to community-based substance abuse outpatient clinics and had a co-occurring mental health problem. Utilization of mental health service was ascertained 3 months post-intake. About one third (35%) of adolescents with a co-occurring mental health problem identified at intake received mental health service in the 3 months after treatment entry. After holding other correlates constant, history of mental health treatment, suicidal behavior, family history of mental disorder and insurance coverage at intake were associated with mental health service utilization at the 3-month follow up. Predictors of service utilization varied by gender and racial/ethnic status. Implications for integrated substance use and mental health services are discussed.     

Examining Relations Between Negative Life Events, Time Spent in the United States, Language Use, and Mental Health Outcomes in Latino Adolescents

Background

Despite the growing number of Latino youth in the US, little research has examined factors that influence the development of mental health symptoms among this population, including factors related to immigration.

Objectives

This study examined the link between negative life events (NLEs) and two outcomes, symptoms of anxiety and engagement in delinquency, among Latino adolescents. Time spent in the US and use of language with family and friends were examined as moderators.

Methods

Study measures were completed by 144 Latino adolescents (N = 78 males; ages 14–19 years) attending a school in a large, Midwestern city.

Results

Multiple regression analyses indicated that exposure to NLEs was the only significant unique predictor of anxiety symptoms, and exposure to NLEs and male gender were significant predictors of engagement in delinquency. Further, an interaction was found between NLEs and language use with friends, indicating that exposure to NLEs is significantly related to engagement in delinquent acts at both high and low use of English with their friends; the magnitude of this association was stronger for low use of English. No other significant interactions were found.

Conclusions

Findings indicate that exposure to NLEs are important to consider for understanding the development of problem behavior among Latino adolescents. Further, the language that Latino youth speak with their friends is important to consider when monitoring these youth for mental and behavioral health symptoms. Interventions geared toward Latino youth should consider both exposure to NLEs and cultural factors to improve the cultural sensitivity of intervention efforts.     

护理专业学生生活事件与心理健康关系研究

目的了解护理专业学生心理健康状况与生活事件的关系，以便为该人群心理健康教育提供依据。方法采用症状自评量表（SCL-90）和生活事件量表，对某医科大学护理专业在校学生469名进行测评。结果护理专业学生SCL-90均分与生活事件总分及各因子分均呈显著正相关。其中，SCL-90均分与生活事件总分（r=0．537）相关最密切。回归分析显示，对护理专业学生心理健康状况影响较大的生活事件因子依次为学习因子、适应因子、人际关系因子。结论应注意减轻护理专业学生的学习压力，注重人际关系训练，提高应对挫折能力，促进心理健康。     

军队医科大学学员生活事件与心理健康的相关分析

目的了解军队医科大学学员心理健康状况与生活事件的关系。方法采用症状自评量表(SCL-90)和自编生活事件量表对4 786名军队医科大学学员的健康水平和生活事件情况进行评估。结果①军队医科大学学员SCL-90各因子的得分在(1.34±0.42)~(1.894±0.59)分之间,均低于国内普通大学生常模(P<0.01);②军队医科大学学员的生活事件与心理健康有明显相关,r值在0.240~0.511之间,相关程度由高至低依次为:学习、适应、人际关系、挫折事件。结论军队医科大学学员心理健康状况较好,与生活事件的影响程度关系密切。     

Risk Factors for Mental Health Problems in School-Age Children from a Community Sample

The epidemiological dimension of mental health problems in childhood and its impact warrant new studies. Knowledge about the predictors of mental health in children is scant in developing countries. The present study estimated the prevalence of psychiatric disorders in Brazilian school-age children based on a community sample from primary health care services, with the aim of verifying the predictive value of biological, social, and familial risk factors in children’s mental health. The study was performed with 120 children of both genders identified through their mothers. The children’s mental health was evaluated by sociodemographic factors and a diagnostic interview conducted with parents. Biological, social, and familial risk factors were evaluated by the Supplemental Questionnaire and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Of the 120 children, 45.8 % were diagnosed with at least one mental health disorder. Children with diagnoses of depressive disorder and generalized anxiety disorder presented evidence of greater exposure to risk factors compared with children without these psychiatric diagnoses. Children with more risk factors throughout their lifetime had greater comorbidities compared with children with a lower number of risk factors. The identification of groups exposed to interconnected risk factors represents a priority when planning mental health practices. The strong role of chronic familial risk factors needs to be emphasized because they are a possible target for the prevention of depressive and anxiety disorders.     

Stressful Life Events,Marital Satisfaction,and Marital Management Skills of Taiwanese Couples

The association between stressful life events and marital satisfaction for 372 Taiwanese couples was examined, as was the moderating effects of three marital management skills (e.g., tolerance/sacrifice, empathy/consideration, soothing/alleviation) on that association. Multilevel modeling analysis showed that stressful life events reduced husbands' and wives' marital satisfaction. Spouses' marital management skills were associated with an increase in their marital satisfaction (actor effects) except for husbands' soothing and alleviation skills. Husbands' tolerance and empathy were also related to an increase in the wife's marital satisfaction (partner effects) and had significant interactions with the relationship between the wife's stress and her marital satisfaction. Husbands' and wives' soothing skills also had significant interactions with the association between stressful life events and their own satisfaction. These results are discussed in relation to the life course, stress process, coping theories, and Chinese cultural values as well as their clinical implications of working with Chinese population.     

大学新生心理健康状况与其人格特征、生活事件的相关研究

目的了解大学新生的总体心理健康水平及其影响因素,为大学生心理健康教育者提供不同的视角和理论依据,使其有针对性地对大学生进行心理辅导和干预。方法利用症状自评量表（SCL-90）、卡特尔16种人格因素量表（16PF）和青少年生活事件量表（ASLEC）,对某高校2009级大一新生身心健康状况进行随机抽样调查,收回有效问卷589份,问卷数据经检查核实后用t检验、多元线性回归分析进行数据分析。结果 2009级新生SCL-90各因子得分中,除强迫症状和恐怖两因子略高于全国大学生常模外,其他各项均低于全国大学生常模;人格特质中抑郁、焦虑等因素以及学习压力等生活事件显著影响了SCL-90得分,差异均有统计学意义（P〈0.01）。结论人格特征和生活事件是影响大学新生心理健康状况的重要因素,因此,培养他们健康的人格、有针对性地进行心理健康教育和引导,对于提高大学生的心理健康有着极其深远的意义。     

大学新生心理健康状况与其人格特征、生活事件的相关研究

目的 了解大学新生的总体心理健康水平及其影响因素,为大学生心理健康教育者提供不同的视角和理论依据,使其有针对性地对大学生进行心理辅导和干预.方法 利用症状自评量表(SCL-90)、卡特尔16种人格因素量表(16PF)和青少年生活事件量表(ASLEC),对某高校2009级大一新生身心健康状况进行随机抽样调查,收回有效问卷589份,问卷数据经检查核实后用t检验、多元线性回归分析进行数据分析.结果 2009级新生SCL-90各因子得分中,除强迫症状和恐怖两因子略高于全国大学生常模外,其他各项均低于全国大学生常模;人格特质中抑郁、焦虑等因素以及学习压力等生活事件显著影响了SCL-90得分,差异均有统计学意义(P<0.01).结论 人格特征和生活事件是影响大学新生心理健康状况的重要因素,因此,培养他们健康的人格、有针对性地进行心理健康教育和引导,对于提高大学生的心理健康有着极其深远的意义.     

Family Dinners,Communication, and Mental Health in Canadian Adolescents

PurposeTo examine the association between the frequency of family dinners and positive and negative dimensions of mental health in adolescents and to determine whether this association is explained by the quality of communication between adolescents and parents.MethodsA community sample of 26,069 adolescents (aged 11 to 15 years) participated in the 2010 Canadian Health Behaviour of School-aged Children study. Adolescents gave self-report data on the weekly frequency of family dinners, ease of parent–adolescent communication, and five dimensions of mental health (internalizing and externalizing problems, emotional well-being, prosocial behavior, and life satisfaction). Regression analyses tested relations between family dinners, parent–adolescent communication, and mental health.ResultsThe frequency of family dinners negatively related to internalizing and externalizing symptoms and positively related to emotional well-being, prosocial behavior, and life satisfaction. These associations did not interact with differences in gender, grade level, or family affluence. However, hierarchical regression analyses found that these associations were partially mediated by differences in parent–adolescent communication, which explained 13% to 30% of the effect of family dinners on mental health, depending on the outcome.ConclusionsThese findings, though correlational, revealed a dose–response association between the frequency of family dinners and positive and negative dimensions of adolescent mental health. The ease of communication between parents and adolescents accounted for some of this association.     

Stressful Life Events and Physical Abuse Among Pregnant Women in North Carolina

Objectives: This study estimates the prevalence of stressful life events and physical abuse among North Carolina women prior to infant delivery, and examines potential associations between abuse and the other stressors. Methods: Data were from the North Carolina Pregnancy Risk Assessment Monitoring System, a statewide representative survey of over 2,600 postpartum women. The survey assessed women's sociodemographic characteristics and their experiences of physical abuse and 13 other stressful life events before delivery. The prevalences of each life event and abuse were estimated. Logistic regression modeled the probability of women having high levels of stressful life events in relation to physical abuse and sociodemographics. Results: Most women were married, white, high school graduates, aged 20 or older. The most common stressful life events were residential moves, increased arguing with husbands/partners, family member hospitalizations, financial hardship, and deaths of loved ones. Fourteen percent of women had high levels of stressful events (5 or more), and almost 9% were physically abused. Abuse was positively associated with increased arguing with husbands/partners, physical fighting, having someone close with an alcohol/drug problem, becoming separated/divorced, and financial hardship. Logistic regression analysis showed that a high level of stressful life events was significantly more likely among women abused both before and during pregnancy (OR = 11.94) and among women abused before but not during pregnancy (OR = 14.19). Conclusions: The high frequency of multiple stressful events and abuse in women's lives suggests that women's care providers should ask their patients about these issues, and offer appropriate referral/interventions to those in need.     

Spanish-Language Community-Based Mental Health Treatment Programs,Policy-Required Language-Assistance Programming,and Mental Health Treatment Access Among Spanish-Speaking Clients

Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities.Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences.Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities.Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.Among the roughly 55.5 million persons in the United States speaking a non-English language at home in 2007, about 34.5 million spoke Spanish; of those Spanish speakers, more than 10 million spoke English “not well” or “not at all”1 and were thus considered persons with limited English proficiency (LEP). Persons with LEP “are unable to communicate effectively in English because their primary language is not English and they have not developed fluency in the English language.”2 In California, the state with the largest Spanish-speaking population in the United States, about 40% of persons aged 5 years or older among the state’s 14 million Latino/Hispanic population are considered persons with LEP.3LEP intersects with sociocultural and immigration-related barriers, thus preventing mentally ill persons with LEP from receiving needed care. Being uninformed about mental illness and interpreting and expressing symptoms of mental illness as something other than mental illness by using a culturally preferred idiom of distress, as well as turning to family and community network members when seeking help who reinforce nonpsychiatric perspectives, can divert persons with LEP from the path to mental health specialty care.4 The stigma associated with mental illness,5 distrust of treatment bureaucracies (S. Leask and L. R. Snowden, unpublished data, 2012), and, for immigrants, fear of being challenged by authorities and asked to account for their immigration status6 create additional barriers.Nonetheless, LEP introduces a significant barrier of its own. Persons with LEP find it difficult to communicate in English language–oriented health care settings,7–9 and they often either do not receive needed health care or receive ineffective care.10–20 Language proficiency may be especially challenging in mental health treatment because psychiatric evaluation hinges on obtaining a thorough history, and because key symptoms are not reflected in directly observable behaviors or signs of morbidity and can be elicited only via self-report.21 Language barriers can prevent recognizing and labeling mental health problems and can interfere with successful communication about treatment needs and care options.22–26According to legal interpretations, executive-branch directives, and US Office of Civil Rights enforcement actions, Title VI of the 1964 Civil Rights Act27 requires recipients of federal funds to provide language assistance services to persons with LEP.28,29 By 2008, every state had passed laws supplementing federal law, further requiring language assistance for persons with LEP seen in health care settings.30To assist in compliance, the US Office of Civil Rights issued guidelines for implementing Title VI requirements. These guidelines call for assessment of the language needs of service-eligible populations and development of written policies to meet needs; training of staff in language assistance policies and procedures; monitoring of the implementation of policy and procedures; provision of trained interpreters; translation of written materials; and notification of beneficiaries that they are entitled to translation assistance free of charge.31Like other mental health agencies, in 1997 the California Department of Mental Health (DMH) adopted a “threshold language access policy” to meet its Title VI obligation for treating persons insured through the state’s Medicaid program, called Medi-Cal.32 Under the policy, threshold status is reached when either 3000 Medi-Cal enrollees in a county or 5% of the county’s Medi-Cal residents, whichever is greater, speak a non-English language. For threshold languages, the policy directs county mental health plans toward a 4-part response: (1) a 24-hour, toll-free phone line with linguistic capability; (2) translated written materials to assist beneficiaries in accessing medically necessary specialty mental health services, including personal correspondence; (3) bilingual clinicians or other bilingual nonstaff, or interpreters or telephonic translation capacity at intake appointments, assessment interviews, treatment sessions, and at other key points of contact; and (4) information to consumers and communities about the availability of these linguistic services, free of charge.One previous study of the threshold policy’s impact in California found that the policy’s mandated language assistance programming increased access to mental health treatment for Vietnamese-speaking and Russian-speaking Medi-Cal beneficiaries, but it found no evidence that access increased for Spanish-speaking beneficiaries.33 However, the study did not examine how counties implemented threshold language programming and could not detect differences associated with the mode of implementation.Contracting with community-based organizations (CBOs) operating specialized treatment programs for non-English-language speakers34,35 is an attractive option for implementing the required language assistance programming. CBOs are

not-for-profit organizations such as non-governmental, civil society organizations, or other grassroots organizations, overseen by an elected board of directors and guided by a strategic plan developed in consultation with community stakeholders.36^(p33)

They operate health and social programs, as well as LEP-focused mental health programs, to fulfill a wider community service mission.36 CBOs seek strong community ties and pursue community oversight and governance; they also practice social, economic, and political advocacy, thereby promoting credibility and community trust.36 Seeking the advantages enjoyed by CBO-operated programs, mental health officials sometimes establish specialized LEP-serving programs operating directly under their authority.A handful of past reports indicated that specialized mental health programs for persons with LEP may be especially effective at bringing them into treatment. In 1 study, Latino and Asian persons with LEP received more outpatient care in such programs than their counterparts seen elsewhere, and their initial contact with a treatment program was significantly less likely to come about via emergency service encounters.37 A second study found that mental health programs specializing in clients speaking Asian languages provided an alternative to threshold language policy requirements for bringing Asian-language speakers into treatment.38We investigated whether access rates for Spanish-language mental health treatment rose for persons with LEP when CBOs’ mental health treatment programs implemented the language assistance programming required by threshold language policy. We hypothesized that, because their goals are closely aligned with addressing the cultural and linguistic orientation and interests of Spanish-speaking communities, and because this enables them to reach out effectively to LEP community members, CBOs’ language assistance programs will promote greater treatment entry than programs that are directly county operated.We also explored whether CBOs’ implementation of language assistance programming was effective and widespread enough to bring about a statewide reduction in the disparity in access between English and Spanish speakers.39 We evaluated any potential increased access experienced by Spanish speakers within a larger framework of disparities in access to mental health treatment. To our knowledge, this study was the first covering a large and diverse region, including a substantial Spanish-speaking population, to assess the effect of CBOs’ implementation of language assistance programming on the accessibility of mental health services for Spanish speakers with LEP. We also assessed reductions in disparities in access to mental health treatment for Spanish versus English speakers.     

生活事件因素对青年学生心理健康水平影响的探讨

为探讨应激事件对青年学生心理健康的影响，采用症状自评量表（ＳＣＬ－９０）和自制青年学生生活事件调查表对郑州市９所大专院校的１５０３人进行调查，并使用ＳＡＳ系统软件进行各种统计学处理。结果表明心理障碍的检出率为２１．２２％。多元逐步回归分析显示：获得或丧失社会支持系统、娱乐和体育等能力不良或良好、学业层次、专业对学生的心理健康有着重要的影响。复相关系数为Ｒ＝０．５５７１，决定系数Ｒ＾２＝０．３１０４     

Rural-Urban Differences in Health Care Benefits of a Community-Based Sample of At-Risk Drinkers

CONTEXT: Different types of health plan cost-containment strategies (eg, gatekeeping, selective contracting, and cost-sharing) may affect the utilization of behavioral health services differently in urban and rural areas. PURPOSE: This research compares the cost-containment strategies used by the health plans of insured at-risk drinkers residing in rural and urban areas. METHODS: A screening instrument for at-risk drinking was administered by phone to approximately 12,000 residents of 6 southern states; 442 at-risk drinkers completed 4 interviews over a 2-year period and consented to release insurance and medical records. Two thirds of the sample (n=294) were insured during the last 6 months of the study. In 1998, health plan characteristics were successfully collected for 217 (72.3%) of the insured at-risk drinkers, representing 113 different health plans and 206 different policies. FINDINGS: Compared with urban at-risk drinkers, rural at-risk drinkers were significantly less likely to be enrolled in a health plan with gatekeeping policies for both behavioral health (P = .001), and physical health (P = .031). Compared with urban enrollees, rural enrollees were significantly more likely to pay deductibles (P = .042), to pay coinsurance for physical health services (P = .002), and to have limits placed on physical health services use (P = .067), but they were less likely to pay copayments for physical health (P = .046). Rural enrollees were less likely to face higher copayments (P = .007) and higher coinsurance (P = .076) for mental health than for physical health, compared to urban enrollees. CONCLUSIONS: Because rural residents were more likely to be enrolled in indemnity plans and less likely to be enrolled in health maintenance organizations, rural at-risk drinkers were enrolled in plans that relied less on supply-side cost-containment strategies and more on demand-side cost-containment strategies targeting physical health service use, compared with their urban counterparts. Rural at-risk drinkers were less likely to be enrolled in health plans with greater cost-sharing for mental health than for physical health compared to urban at-risk drinkers.