Loss of group memberships predicts depression in postpartum mothers

Purpose

The postpartum period presents the highest risk for women’s mental health throughout the lifespan. We aimed to examine the Social Identity Model of Identity Change in this context. More specifically, we investigated changes in social identity during this life transition and their consequences for women’s postpartum mental health.

Methods

Women who had given birth within the last 12 months (N = 387) reported on measures of depression, social group memberships, and motherhood identification.

Results

Analyses indicated that a decrease in group memberships after having a baby, controlling for group memberships prior to birth, was associated with an increase in depressive symptomology. However, maintaining pre-existing group memberships was predictive of better mental health. New group memberships were not associated with depressive symptomology. Identification as a mother was a strong positive predictor of mental health in the postpartum period.

Conclusions

The social identity model of identity change provides a useful framework for understanding postpartum depression. Interventions to prevent and treat postpartum depression might aim to support women in maintaining important social group networks throughout pregnancy and the postpartum period.

     

Traumatic exposure,acculturative stress and cultural orientation: the influence on PTSD,depressive and anxiety symptoms among refugees

Objective

Acculturation studies conducted with refugees have predominantly concentrated on investigating the impact of acculturative stress on mental health, and have neglected to investigate the impact of cultural orientations towards the host and ethnic cultures. Furthermore, exposure to traumas is highly prevalent in refugees and strongly associated with mental health outcomes, however, rarely included in investigations of acculturative process of refugees.

Method

Using structural equation modelling, this study tested an integrated model of the relationship between traumatic exposure, acculturative stress, host and ethnic cultural orientations and posttraumatic stress disorder (PTSD), depression and anxiety symptoms among 138 Bosnian refugees resettled in Australia and Austria.

Results

The model showed an overall good fit and noteworthy amount of variance indicating that traumatic exposure is the strongest direct and indirect predictor of PTSD, depression and anxiety symptoms. Furthermore, acculturative stress was identified as a significant risk factor influencing host cultural orientation, mediating the effect of traumatic exposure on all mental health outcomes.

Conclusion

Acculturative stress and cultural and social stressors that are related to acculturation need to be addressed alongside provision of effective psychotherapy, especially since they are significant impediments to host cultural orientation and constructive engagement with mental health services in refugees.

     

Social Determinants of Mental Health: Where We Are and Where We Need to Go

Purpose of Review

The present review synthesizes recent literature on social determinants and mental health outcomes and provides recommendations for how to advance the field. We summarize current studies related to changes in the conceptualization of social determinants, how social determinants impact mental health, what we have learned from social determinant interventions, and new methods to collect, use, and analyze social determinant data.

Recent Findings

Recent research has increasingly focused on interactions between multiple social determinants, interventions to address upstream causes of mental health challenges, and use of simulation models to represent complex systems. However, methodological challenges and inconsistent findings prevent a definitive understanding of which social determinants should be addressed to improve mental health, and within what populations these interventions may be most effective.

Summary

Recent advances in strategies to collect, evaluate, and analyze social determinants suggest the potential to better appraise their impact and to implement relevant interventions.

     

Visual perception and processing in children with 22q11.2 deletion syndrome: associations with social cognition measures of face identity and emotion recognition

Background

People with 22q11.2 deletion syndrome (22q11DS) have difficulty processing social information including facial identity and emotion processing. However, difficulties with visual and attentional processes may play a role in difficulties observed with these social cognitive skills.

Methods

A cross-sectional study investigated visual perception and processing as well as facial processing abilities in a group of 49 children and adolescents with 22q11DS and 30 age and socio-economic status-matched healthy sibling controls using the Birmingham Object Recognition Battery and face processing sub-tests from the MRC face processing skills battery.

Results

The 22q11DS group demonstrated poorer performance on all measures of visual perception and processing, with greatest impairment on perceptual processes relating to form perception as well as object recognition and memory. In addition, form perception was found to make a significant and unique contribution to higher order social-perceptual processing (face identity) in the 22q11DS group.

Conclusions

The findings indicate evidence for impaired visual perception and processing capabilities in 22q11DS. In turn, these were found to influence cognitive skills needed for social processes such as facial identity recognition in the children with 22q11DS.

     

A review of social participation interventions for people with mental health problems

Purpose

The association between social networks and improved mental and physical health is well documented in the literature, but mental health services rarely routinely intervene to improve an individual’s social network. This review summarises social participation intervention models to illustrate different approaches which practitioners use, highlight gaps in the evidence base and suggest future directions for research.

Methods

A systematic search of electronic databases was conducted, and social participation interventions were grouped into six categories using a modified narrative synthesis approach.

Results

Nineteen interventions from 14 countries were identified, six of which were evaluated using a randomised controlled trial. They were grouped together as: individual social skills training; group skills training; supported community engagement; group-based community activities; employment interventions; and peer support interventions. Social network gains appear strongest for supported community engagement interventions, but overall, evidence was limited.

Conclusions

The small number of heterogeneous studies included in this review, which were not quality appraised, tentatively suggests that social participation interventions may increase individuals’ social networks. Future research needs to use experimental designs with sufficient samples and follow-up periods longer than 12 months to enable us to make firm recommendations for mental health policy or practice.

     

Intersections of discrimination due to unemployment and mental health problems: the role of double stigma for job- and help-seeking behaviors

Purpose

The everyday lives of unemployed people with mental health problems can be affected by multiple discrimination, but studies about double stigma—an overlap of identities and experiences of discrimination—in this group are lacking. We therefore studied multiple discrimination among unemployed people with mental health problems and its consequences for job- and help-seeking behaviors.

Methods

Everyday discrimination and attributions of discrimination to unemployment and/or to mental health problems were examined among 301 unemployed individuals with mental health problems. Job search self-efficacy, barriers to care, and perceived need for treatment were compared among four subgroups, depending on attributions of experienced discrimination to unemployment and to mental health problems (group i); neither to unemployment nor to mental health problems (group ii); mainly to unemployment (group iii); or mainly to mental health problems (group iv).

Results

In multiple regressions among all participants, higher levels of discrimination predicted reduced job search self-efficacy and higher barriers to care; and attributions of discrimination to unemployment were associated with increased barriers to care. In ANOVAs for subgroup comparisons, group i participants, who attributed discrimination to both unemployment and mental health problems, reported lower job search self-efficacy, more perceived stigma-related barriers to care and more need for treatment than group iii participants, as well as more stigma-related barriers to care than group iv.

Conclusions

Multiple discrimination may affect job search and help-seeking among unemployed individuals with mental health problems. Interventions to reduce public stigma and to improve coping with multiple discrimination for this group should be developed.

     

Social distance in Lithuanian psychology and social work students and professionals

Purpose

This cross-sectional study aimed to compare desire for social distance from people with mental illness in the disciplines of social work and psychology, and among students and professionals having different professional experience.

Methods

948 respondents (715 students and 233 professionals) from Lithuanian educational and mental health-care institutions participated in an anonymous survey. Social distance was measured using Lithuanian Social Distance Scale which was created for this study. Participants also answered questions about familiarity with mental illness. Bias of social desirability was measured using the balanced inventory of desirable responding.

Results

Series of ANCOVA analysis revealed that psychology and social work master’s and PhD students reported less social distance from people with mental illness when compared with bachelor’s students. Familiarity with mental illness was significantly related to less social distance in the student sample, but not in professionals’ sample. The strongest desire for social distance in the professionals’ sample was observed in social workers having less than 5 years of professional practice and most experienced psychologists with more than 10 years of professional practice.

Conclusions

Social distance from people with mental illness decreases through the study years; however, results of professional psychologists and social workers illustrate different trajectories in social distance through the professional career. The results of this study support the need for anti-stigma programmes and initiatives orientated towards mental health professionals.

     

Non-suicidal Self-Injury in Adolescence

Purpose of Review

Non-suicidal self-injury (NSSI) is a common mental health threat among adolescents. This review aims to present the current literature on epidemiology, etiology, and therapeutic approaches with a focus on the period of adolescence.

Recent Findings

NSSI is widespread among adolescents both in community as well as in clinical settings with lifetime prevalence rates between 17 and 60% in recent studies. It is influenced by multiple factors including social contagion, interpersonal stressors, neurobiological background, as well as emotional dysregulation and adverse experiences in childhood.

Summary

There is still a lack of studies regarding the psychotherapeutic as well as the psychopharmacological treatment of NSSI in adolescence. Furthermore, sufficient evidence for prevention programs is missing.

     

Perceived stigma among non-professional caregivers of people with severe mental illness,Bahir Dar,northwest Ethiopia

Background

The stigmatization of mental illness is currently considered to be one of the most important issues facing caregivers of severely mentally ill individuals. There is a dearth of information about the prevalence and associated factors of perceived stigma among caregivers of people with severe mental illness in the study area.

Objective

To assess the prevalence and associated factors of perceived stigma among non-professional caregivers of people with severe mental illness, Bahir Dar, northwest Ethiopia.

Method

Institutional based cross-sectional study was conducted from May to June, 2016 at Felege Hiwot Referral Hospital among 495 caregivers of people with the severe mental illness. Pre-tested structured family interview schedule questionnaire was used. Binary logistic regression was applied to identify factors associated with perceived stigma and interpreted using odds ratio with 95% confidence interval. Statistical significance was considered at p value?<?0.05.

Result

The overall prevalence of perceived stigma was found to be 89.3%. Being female, rural residency, lack of social support, long duration of relationship with the patient and currently not married were found significantly associated with the perceived stigma of caregivers.

Conclusion

Prevalence of perceived stigma is very high in the current study. Thus, stigma reduction program and expanding of strong social support should better be implemented by different stakeholders for caregivers of people with severe mental illness.

     

Gender difference in QTc prolongation of people with mental disorders

Background

We examined gender difference in QTc interval distribution and its related factors in people with mental disorders.

Methods

We retrospectively reviewed medical charts of patients discharged from a university psychiatric unit between November 1997 and December 2000. Subjects were 328 patients (145 males and 183 females) taking psychotropics at their admission. We examined patient characteristics, medical history, diagnosis, and medication before admission.

Results

Mean QTc interval was 0.408 (SD = 0.036). QTc intervals in females were significantly longer than those in males. QTc of females without comorbidity was significantly longer than that of males.

Conclusion

The influence of gender difference on QTc prolongation in people with mental disorders merits further research.

     

Immigrants from Mexico experience serious behavioral and psychiatric problems at far lower rates than US-born Americans

Purpose

To examine the prevalence of self-reported criminal and violent behavior, substance use disorders, and mental disorders among Mexican immigrants vis-à-vis the US born.

Methods

Study findings are based on national data collected between 2012 and 2013. Binomial logistic regression was employed to examine the relationship between immigrant status and behavioral/psychiatric outcomes.

Results

Mexican immigrants report substantially lower levels of criminal and violent behaviors, substance use disorders, and mental disorders compared to US-born individuals.

Conclusion

While some immigrants from Mexico have serious behavioral and psychiatric problems, Mexican immigrants in general experience such problems at far lower rates than US-born individuals.

     

A typology of satisfaction with mental health services based on Andersen’s behavioral model

Objective

Patients with mental disorders (MDs) form a highly heterogeneous group, whose satisfaction with mental health services (MHS) may vary according to different variables. Identifying patient subgroups with similar levels of satisfaction may help identify variables that contribute to satisfaction or dissatisfaction with services. This study established a typology of patient satisfaction with MHS that revealed variables specific to each group.

Methods

The study included 325 patients with MDs across four health service networks offering integrated and diversified services. Data were collected using five standardized instruments, and participant medical records. A conceptual framework was developed, based on Andersen’s Behavioral Model, which integrates socio-demographic, clinical, needs-related and service use variables. Using cluster analysis, a typology of patient satisfaction was created.

Results

Analyses yielded four patient clusters: two where levels of satisfaction were relatively high and two with lower levels of satisfaction (range 3.74–4.37). Greater care continuity and higher income related to greater patient satisfaction; whereas co-occurring MDs and substance use disorders (SUD), as well as more numerous and severe needs, characterized dissatisfied patients who were frequent users of MHS.

Conclusions

Results highlight the need for continuity of care and adequate socio-economic conditions for increasing patient satisfaction with MHS. Lower levels of satisfaction among patients with common MDs and SUDs suggest the importance of addressing their specific needs to enhance satisfaction and MH recovery.

     

Interventions to mitigate the effects of poverty and inequality on mental health

Purpose

To review psychosocial and policy interventions which mitigate the effects of poverty and inequality on mental health.

Methods

Systematic reviews, controlled trials and realist evaluations of the last 10 years are reviewed, without age or geographical restrictions.

Results

Effective psychosocial interventions on individual and family level, such as parenting support programmes, exist. The evidence for mental health impact of broader community-based interventions, e.g. community outreach workers, or service-based interventions, e.g. social prescribing and debt advice is scarce. Likewise, the availability of evidence for the mental health impact of policy level interventions, such as poverty alleviation or youth guarantee, is quite restricted.

Conclusions

The social, economic, and physical environments in which people live shape mental health and many common mental disorders. There are effective early interventions to promote mental health in vulnerable groups, but it is necessary to both initiate and facilitate a cross-sectoral approach, and to form partnerships between different government departments, civic society organisations and other stakeholders. This approach is referred to as Mental Health in All Policies and it can be applied to all public policy levels from local policies to supranational.

     

Girls get by with a little help from their friends: gender differences in protective effects of social support for psychotic phenomena amongst poly-victimised adolescents

Purpose

To investigate whether social support is protective for psychotic experiences similarly among poly-victimised adolescent girls and boys.

Methods

We utilised data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative sample of 2232 UK-born twins. Participants were privately interviewed at age 18 about victimisation, psychotic experiences, and social support during adolescence.

Results

Perceived social support (overall and from friends) was found to be protective against psychotic experiences amongst poly-victimised adolescent girls, but not boys. Though boys were similarly protected by family support.

Conclusions

Social support-focused interventions targeting psychotic phenomena amongst poly-victimised adolescents may be more effective for girls.

     

Familien von anfallskranken Kindern

Background

Epilepsy has an impact on not only the affected child, but also the whole family, especially the parents.

Aim of the study

To give an overview of the psychosocial impact of a child’s epilepsy on his/her family.

Methods

This overview is based on a selection of primary studies, which were mainly identified by a PubMed search.

Results

Besides various worries, high support needs, and mental health problems on the part of the parents, the epilepsy of a child also leads to stress for their siblings and strains in the relationships within the family. Furthermore, there are several limitations both in everyday life and in the social activities of the affected families. The presence of additional behavioral or health problems in children has been found to be an important factor influencing the impact of epilepsy on families.

Conclusion

In a comprehensive treatment approach for children and adolescents with epilepsy, the disease-related burdens of the family should be taken into account and psychosocial support should be provided.

     

General practitioners’ experiences and perceptions of mild moderate depression management and factors influencing effective service delivery in rural Australian communities: a qualitative study

Background

Rural communities in Australia face significant disadvantages relating to geographical isolation and limited access to mental health services. Documenting general practitioners’ (GP) experiences and perception of mental health services in rural Australia may be useful to gain insight into rural GP management of mild to moderate depression.

Aims

To explore GPs’ experience and views on which factors influence access to mental health services for mild to moderate depression.

Method

This qualitative study was conducted in 2014 in the Northern Rivers, NSW, Australia. Data were obtained from semi-structured in-depth face-to-face interviews with ten GPs, and analyses were performed using a general inductive method of thematic analysis.

Results

Most GPs believed that the current services for managing mild-moderate depression were adequate, however they also identified the need for better access and more services that were free for patients. GPs had a positive perception of management of depression in a rural setting, identifying advantages including better doctor-patient relationships, continuity of care and the proximity of services. However, GPs also identified several barriers to access to mental health services in a rural setting, including long waiting-times, inadequate patient rapport with referred professionals, cost of treatment, transportation, geographical location, stigma, and lack of education about available mental health services. As a result, GPs frequently self-managed patients in addition to referring them to other community mental health service providers where possible.

Conclusion

Overall, GPs appeared relatively satisfied with the resources available in their communities but also identified numerous barriers to access and room for improvement. Rural GPs often self-managed patients in addition to referring patients to other mental health services providers. This should be taken into account when designing mental health policies, developing new services or re-designing current services in rural communities.

     

Predictors of Moderate-to-Vigorous Physical Activity (MVPA) in African American Young Adolescents

Background

African American adolescents residing in the South are at increased risk for obesity and physical inactivity, yet our understanding of potential influences is limited.

Purpose

Using an ecological framework, this study explored multilevel predictors (individual, family, home, and neighborhood environment) of moderate-to-vigorous physical activity (MVPA) among 116 African American adolescents (ages 12–16).

Methods

Adolescents and their parents completed self-report surveys for hypothesized predictors. Youth physical activity was measured using accelerometry.

Results

In multiple regression models, decreased daily MVPA was associated with female sex (β?=??24.27, p?<?0.0001). Family social support (β?=?1.07, p?=?0.004) and adolescent self efficacy for PA (β?=?6.89, p?=?0.054) were positively associated with daily MVPA.

Conclusions

Adolescent demographics along with family social support and self-efficacy influence younger African American adolescent physical activity. Further exploration of the complex interaction of multiple levels of influence is needed to develop appropriate interventions for this vulnerable group.

     

Neighborhood determinants of mood and anxiety disorders among men who have sex with men in New York City

Purpose

We examined the relationship between economic, physical, and social characteristics of neighborhoods, where men who have sex with men (MSM) lived and socialized, and symptom scores of depression and generalized anxiety disorder (GAD).

Methods

Participants came from a cross-sectional study of a population-based sample of New York City MSM recruited in 2010–2012 (n?=?1126). Archival and survey-based data were obtained on neighborhoods, where the men lived and where they socialized most often.

Results

MSM who socialized in neighborhoods with more economic deprivation and greater general neighborhood attachment experienced higher GAD symptoms. The relationship between general attachment to neighborhoods where MSM socialized and mental health depended on the level of gay community attachment: in neighborhoods characterized by greater gay community attachment, general neighborhood attachment was negatively associated with GAD symptoms, while in low gay community attachment neighborhoods, general neighborhood attachment had a positive association with GAD symptoms.

Conclusions

This study illustrates the downsides of having deep ties to social neighborhoods when they occur in the absence of broader access to ties with the community of one’s sexual identity. Interventions that help MSM cross the spatial boundaries of their social neighborhoods and promote integration of MSM into the broader gay community may contribute to the reduction of elevated rates of depression and anxiety in this population.

     

Social isolation in mental health: a conceptual and methodological review

Purpose

Social isolation and related concepts have been discussed increasingly in the field of mental health. Despite this, there is a lack of conceptual clarity and consistency in the definition and operationalisation of these terms. This review aimed to provide a clear framework for social isolation and related concepts, and to identify well-established measures in the field of mental health for each conceptual domain discussed.

Methods

We used an iterative strategy of expert consultation and literature searching. A multi-disciplinary group of senior academics was consulted both before and after the literature searching to identify relevant terms, conceptual papers, or recommended measures. Our conceptual framework was also validated through expert consultation. We searched the Web of Science database using terms suggested by experts and subsequently identified further relevant studies through review articles and by reading full texts and reference lists of included studies. A narrative synthesis was conducted.

Results

We developed a model with five domains incorporating all the concepts relevant to social isolation in regular use in the mental health research literature. These five domains are: social network—quantity; social network—structure; social network—quality; appraisal of relationships—emotional; and appraisal of relationships—resources. We also identified well-developed measures suitable for assessing each of the five conceptual domains or covering multi-domains.

Conclusions

Our review proposes a conceptual model to encompass and differentiate all terms relating to social isolation. Potential uses are in allowing researchers and intervention developers to identify precisely the intended outcomes of interventions, and to choose the most appropriate measures to use in mental health settings.