Mental health literacy and attitudes in a Swedish community sample – Investigating the role of personal experience of mental health care

Background

The role of social and family environments in the development of mental health problems among children and youth has been widely investigated. However, the degree to which parental working conditions may impact on developmental psychopathology has not been thoroughly studied.

Methods

We conducted a case-control study of several mental health outcomes of 19,833 children of sawmill workers and their association with parental work stress, parental socio-demographic characteristics, and paternal mental health.

Results

Multivariate analysis conducted with four distinct age groups (children, adolescents, young adults, and adults) revealed that anxiety based and depressive disorders were associated with paternal work stress in all age groups and that work stress was more strongly associated with alcohol and drug related disorders in adulthood than it was in adolescence and young adulthood.

Conclusion

This study provides support to the tenet that being exposed to paternal work stress during childhood can have long lasting effects on the mental health of individuals.     

Question order sensitivity of subjective well-being measures: focus on life satisfaction,self-rated health,and subjective life expectancy in survey instruments

Purpose

This study examines the effect of question context created by order in questionnaires on three subjective well-being measures: life satisfaction, self-rated health, and subjective life expectancy.

Methods

We conducted two Web survey experiments. The first experiment (n = 648) altered the order of life satisfaction and self-rated health: (1) life satisfaction asked immediately after self-rated health; (2) self-rated health immediately after life satisfaction; and (3) two items placed apart. We examined their correlation coefficient by experimental condition and further examined its interaction with objective health. The second experiment (n = 479) asked life expectancy before and after parental mortality questions. Responses to life expectancy were compared by order using ANOVA, and we examined interaction with parental mortality status using ANCOVA. Additionally, response time and probes were examined.

Results

Correlation coefficients between self-rated health and life satisfaction differed significantly by order: 0.313 (life satisfaction first), 0.508 (apart), and 0.643 (self-rated health first). Differences were larger among respondents with chronic conditions. Response times were the shortest when self-rated health was asked first. When life expectancy asked after parental mortality questions, respondents reported considering parents more for answering life expectancy; and respondents with deceased parents reported significantly lower expectancy, but not those whose parents were alive.

Conclusion

Question context effects exist. Findings suggest placing life satisfaction and self-rated health apart to avoid artificial attenuation or inflation in their association. Asking about parental mortality prior to life expectancy appears advantageous as this leads respondents to consider parental longevity more, an important factor for true longevity.

     

Systematic development of a self-regulation weight-management intervention for overweight adults

Background

Little is known about differences in professional care seeking based on marital status. The few existing studies show more professional care seeking among the divorced or separated compared to the married or cohabiting. The aim of this study is to determine whether, in a sample of the European general population, the divorced or separated seek more professional mental health care than the married or cohabiting, regardless of self-reported mental health problems. Furthermore, we examine whether two country-level features--the supply of mental health professionals and the country-level divorce rates--contribute to marital status differences in professional care-seeking behavior.

Methods

We use data from the Eurobarometer 248 on mental well-being that was collected via telephone interviews. The unweighted sample includes 27,146 respondents (11,728 men and 15,418 women). Poisson hierarchical regression models were estimated to examine whether the divorced or separated have higher professional health care use for emotional or psychological problems, after controlling for mental and somatic health, sociodemographic characteristics, support from family and friends, and degree of urbanization. We also considered country-level divorce rates and indicators of the supply of mental health professionals, and applied design and population weights.

Results

We find that professional care seeking is strongly need based. Moreover, the divorced or separated consult health professionals for mental health problems more often than people who are married or who cohabit do. In addition, we find that the gap between the divorced or separated and the married or cohabiting is highest in countries with low divorce rates.

Conclusions

The higher rates of professional care seeking for mental health problems among the divorced or separated only partially correlates with their more severe mental health problems. In countries where marital dissolution is more common, the marital status gap in professional care seeking is narrower, partially because professional care seeking is more common among the married or cohabiting.     

Disruptive behavior in childhood and socioeconomic position in adulthood: a prospective study over 27 years

Objectives

We examined whether childhood disruptive behavior (aggressiveness, hyperactivity and social adjustment), predicts adulthood socioeconomic position (SEP), i.e., educational level, occupational status and income and social mobility.

Methods

Social mobility was defined by comparing the participants’ adulthood socioeconomic position with that of their parents (“intergenerational social mobility”). The subjects were derived from a population-based cohort study (N = 3,600) and our sample consisted of 782 participants (403 women) aged 3–9 years at baseline and were followed until they were aged 30–36.

Results

High childhood aggression associated with low educational level and occupational status suggesting an early beginning negative tracking of aggressive behavior. High hyperactivity and poor social adjustment predicted adulthood low occupational status proposing a more slow effect on adulthood SEP. No associations between disruptive behavior and income-related mobility were found, but high hyperactivity associated with educational downward drift, whereas high aggression and low social adjustment related with occupational downward drift.

Conclusions

Results suggest that childhood disruptive behavior may have long-lasting negative effects. In order to reduce the adverse effects of disruptive behavior, early intervention of problematic behavior becomes salient.     

Positive Youth, Healthy Adults: Does Positive Well-being in Adolescence Predict Better Perceived Health and Fewer Risky Health Behaviors in Young Adulthood?

Purpose

To examine the prospective, longitudinal associations between positive well-being during adolescence and health outcomes in young adulthood, using a large, nationally representative sample of youth.

Methods

On the basis of the data from the first three waves of the National Longitudinal Study of Adolescent Health, we examined positive well-being during adolescence (averaged across Waves I-II) as a predictor of perceived young adult general health and risky health behaviors (Wave III). Each model included a full set of health and demographic baseline covariates. Missing values were assigned using multiple imputation methods (n = 10,147).

Results

Positive well-being during adolescence was significantly associated with reporting better perceived general health during young adulthood, independent of depressive symptoms. Positive well-being was also significantly associated with fewer risky health behaviors in Wave III, after adding all covariates, including depressive symptoms and baseline risky health behaviors.

Conclusion

Few studies of adolescent health have examined positive psychological characteristics, tending to focus instead on the effect of negative mood states and cognitions on health. This study demonstrates that positive well-being during adolescence predicts better perceived general health and fewer risky health behaviors during young adulthood. Aligned with the goals of the positive youth development perspective, promoting and nurturing positive well-being during the transition from childhood to adolescence may present a promising way to improve long-term health.     

Innovations in health care and mortality trends from five cancers in seven European countries between 1970 and 2005

Objectives

Although the contribution of health care to survival from cancer has been studied extensively, much less is known about its contribution to population health. We examine how medical innovations have influenced trends in cause-specific mortality at the national level.

Methods

Based on literature reviews, we selected six innovations with proven effectiveness against cervical cancer, Hodgkin’s disease, breast cancer, testicular cancer, and leukaemia. With data on the timing of innovations and cause-specific mortality (1970–2005) from seven European countries we identified associations between innovations and favourable changes in mortality.

Results

For none of the five specific cancers, sufficient evidence for an association between introduction of innovations and a positive change in mortality could be found. The highest association was found between the introduction of Tamoxifen and breast cancer mortality.

Conclusions

The lack of evidence of health care effectiveness may be due to gradual improvements in treatment, to effects limited to certain age groups or cancer subtypes, and to contemporaneous changes in cancer incidence. Research on the impact of health care innovations on population health is limited by unreliable data on their introduction.     

The embodiment of adverse childhood experiences and cancer development: potential biological mechanisms and pathways across the life course

Objectives

To explore current evidence of the physiological embedding of stress to discuss whether adverse childhood experiences (ACE) causing chronic or acute stress responses may alter fundamental biological functions.

Methods

A non-systematic review of the literature was carried out using keyword searches in Pubmed and the web of science from May to October 2011. In reference to the literature identified, we examine the potential biological pathways potentially linking exposure to ACE and cancer development and progression in adulthood.

Results

These mechanisms, in interaction with social position, and mediated by subsequent environmental exposures, may ultimately lead to the development of cancer. The experience of acute or chronic stressors during sensitive periods of childhood development which can induce several known biological responses, are likely to have an impact on subsequent biological and behavioural functions depending on the timing of initial exposures, and subsequently mediated by later exposures. For this reason, childhood exposure to adversity is a likely source of both acute and chronic stressors, and can be examined as an important initial exposure on a pathway towards adult ill health.

Conclusions

Such pathways justify a life course approach to understanding cancer aetiology, which may have its origins early in life.     

Psychosocial working conditions and psychological well-being among employees in 34 European countries

Purpose

The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country.

Methods

The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests.

Results

When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong.

Conclusions

A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.     

Impact of psychological and cancer-related factors on HRQoL for Korean childhood cancer survivors

Purpose

The purposes of this study were (1) to compare health-related quality of life (HRQoL) between Korean childhood cancer survivors and healthy controls and (2) to examine the impact of demographic, diagnosis/treatment, and psychological variables on physical and psychosocial health in survivors.

Methods

The HRQoL (PedsQL), Self-Concept Inventory, and Child Behavior Checklist were administered to childhood cancer survivors, age/gender-matched healthy counterparts, and their parents. Independent-samples t tests and hierarchical multiple regression analyses were conducted.

Results

Compared with healthy controls, childhood cancer survivors reported significantly lower scores across physical and psychosocial HRQoL. For survivors, demographic, diagnosis/treatment, current health status, and psychological variables explained more than 50 % of the variance in both subscales of HRQoL. Especially, self-concept, a psychological variable, explained a significant portion of the variance in physical and psychosocial HRQoL after controlling for cancer-related factors. Several cancer-related factors including time since treatment completion, having a history of allogeneic hematopoietic stem cell transplantation, multiple treatment modalities, and suffering from severe late effects also associated with specific dimension of HRQoL.

Conclusions

Childhood cancer survivors do experience lower level of QoL and psychological factors, especially self-concept, should be considered when supporting the well-being of childhood cancer survivors.     

Young children’s screen habits are associated with consumption of sweetened beverages independently of parental norms

Objectives

This study investigated the associations between children’s screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child’s screen and dietary habits in a similar direction, our specific aim was to examine whether these associations were independent of parental norms.

Methods

In the Swedish sample of the European Identification and prevention of dietary and lifestyle-induced health effects in children and infants (IDEFICS) study, parents filled in questionnaires about their 2 to 9-year-old children’s (n = 1,733) lifestyle and diets.

Results

Associations between screen habits and sweetened beverage consumption were found independent of parental norms regarding sweetened beverages. A longitudinal analysis revealed that sweetened beverage consumption at 2-year follow-up was predicted by exposure to commercial TV at baseline (OR 1.4, 95 % CI 1.1–1.9). Cross-sectional analysis showed that the likelihood of consuming sweetened beverages at least 1–3 times per week increased for each hour/day watching television (OR 1.5, 95 % CI 1.2–1.9), and for being exposed to commercials (OR 1.6, 95 % CI 1.3–2.1). TV viewing time and commercial exposure contributed to the associations independently of each other.

Conclusions

The results strengthen the assumption that it is possible to influence children’s dietary habits through their TV habits.     

Urban sprawl,obesity, and cancer mortality in the United States: cross-sectional analysis and methodological challenges

Background

Urban sprawl has the potential to influence cancer mortality via direct and indirect effects on obesity, access to health services, physical activity, transportation choices and other correlates of sprawl and urbanization.

Methods

This paper presents a cross-sectional analysis of associations between urban sprawl and cancer mortality in urban and suburban counties of the United States. This ecological analysis was designed to examine whether urban sprawl is associated with total and obesity-related cancer mortality and to what extent these associations differed in different regions of the US. A major focus of our analyses was to adequately account for spatial heterogeneity in mortality. Therefore, we fit a series of regression models, stratified by gender, successively testing for the presence of spatial heterogeneity. Our resulting models included county level variables related to race, smoking, obesity, access to health services, insurance status, socioeconomic position, and broad geographic region as well as a measure of urban sprawl and several interactions. Our most complex models also included random effects to account for any county-level spatial autocorrelation that remained unexplained by these variables.

Results

Total cancer mortality rates were higher in less sprawling areas and contrary to our initial hypothesis; this was also true of obesity related cancers in six of seven U.S. regions (census divisions) where there were statistically significant associations between the sprawl index and mortality. We also found significant interactions (p?<?0.05) between region and urban sprawl for total and obesity related cancer mortality in both sexes. Thus, the association between urban sprawl and cancer mortality differs in different regions of the US.

Conclusions

Despite higher levels of obesity in more sprawling counties in the US, mortality from obesity related cancer was not greater in such counties. Identification of disparities in cancer mortality within and between geographic regions is an ongoing public health challenge and an opportunity for further analytical work identifying potential causes of these disparities. Future analyses of urban sprawl and health outcomes should consider exploring regional and international variation in associations between sprawl and health.     

Development of the Healthy Pathways Child-Report Scales

Purpose

The Child Health and Illness Profile (CHIP) has separate child (6–11 years) and adolescent (12–21 years) editions that measure youth’s self-assessed health, illness, and well-being. The purpose of this study was to revise the CHIP by combining the two editions to create the Healthy Pathways Child-Report Scales.

Methods

We modified the original CHIP domains of Comfort, Risk Avoidance, Satisfaction, and Resilience to reflect advances in child health conceptualization. Classical test and item response theory psychometric analyses were conducted using data collected from 2,095 children (49% boys, 80% White, 17% African-American, 3% Hispanic, Age: M = 10.6, SD = 1.0) in grades 4–6 at 34 schools.

Results

After minor revisions, 16 of the 17 scales were found to measure unidimensional self-assessed health, illness, and well-being constructs comprehensively, but with a minimal number of items. Scales were unbiased by age, gender, survey modality, and geographic location. Construct validity was demonstrated by the instrument’s capacity to differentiate among children with and without chronic illnesses and to detect expected age and gender differences.

Conclusions

The Healthy Pathways Child-Report Scales may be used to reliably and accurately assess unidimensional aspects of health, illness, and well-being in clinical and population-based research studies involving youth in transition from childhood to adolescence.     

Culture in Prenatal Development: Parental Attitudes,Availability of Care,Expectations, Values,and Nutrition

Background

Culture is a universal phenomenon, but most interest about culture during pregnancy has focused on medical care, neglecting psychological aspects of normative development.

Objective

The purpose of this article was to examine normative gestational experiences using the framework of a broaden and build model of culture, positive pregnancy, and youth development.

Methods

The review involved 43 studies, books, and book chapters (1981–2013) obtained from electronic databases, focusing on parental attitudes, available care, parental expectations, cultural values, and nutrition likely to affect the unborn.

Results

Several protective factors emerged, such as positive expectations, early prenatal care, protective cultural values, appropriate nutrition, sensitive health care providers, and interdependent, supportive relationships; the absence of some of these protective factors predicted prenatal, perinatal or postnatal complications, likely to affect the health and mental health of youth.

Conclusions

The review’s findings are congruent with theoretical propositions. Positive feelings and expectations broaden prenatal care, adequate nutrition and avoidance of substance use. In turn, these positive activities help build social support and interdependent relationships that promote maternal and infant health, in the context of protective cultural norms.     

Development of the Healthy Pathways Parent-Report Scales

Purpose

To describe the development of the Healthy Pathways Parent-Report Scales, measures of health, illness, well-being, and achievement among youth in middle childhood and adolescence.

Methods

The Healthy Pathways Scales were derived from the Child Health and Illness Profile (CHIP) instruments. The CHIP domains of Comfort, Risk Avoidance, Satisfaction, and Resilience were modified to reflect advances in child health conceptualization. Classical test and modern psychometric analyses were conducted using data collected from 1,527 parents of children aged 9?C14?years. Intra-class correlation and differential item functioning analyses were used to evaluate the extent of child?Cparent agreement on the Healthy Pathways Scales.

Results

After minor revisions, 11 of the 12 scales were found to measure unidimensional parent-assessed outcomes comprehensively (full range of the latent trait) and efficiently (a minimal number of items). Scales were unbiased by age, gender, and geographic location. The construct validity of the scales was supported by their capacity to differentiate children with and without chronic illnesses and to detect expected age and gender differences. Child?Cparent agreement was poor to moderate at both the scale and item levels.

Conclusions

The Healthy Pathways Parent-Report Scales may be used to reliably, accurately, and efficiently assess unidimensional aspects of health, illness, well-being, and achievement in clinical and population-based research studies involving youth in middle childhood and adolescence.     

Prevalence of negative life events and chronic adversities in European pre- and primary-school children: results from the IDEFICS study

Background

Children are not always recognized as being susceptible to stress, although childhood stressors may originate from multiple events in their everyday surroundings with negative effects on children’s health.

Methods

As there is a lack of large-scale, European prevalence data on childhood adversities, this study presents the prevalence of (1) negative life events and (2) familial and social adversities in 4637 European pre- and primary-school children (4–11 years old), using a parentally-reported questionnaire embedded in the IDEFICS project (‘Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS’).

Results

The following findings were observed: (1) Certain adversities occur only rarely, while others are very regular (i.e. parental divorce); (2) A large percentage of children is shielded from stressors, while a small group of children is exposed to multiple, accumulating adversities; (3) The prevalence of childhood adversity is influenced by geographical location (e.g. north versus south), age group and sex; (4) Childhood adversities are associated and co-occur, resulting in potential cumulative childhood stress.

Conclusions

This study demonstrated the importance of not only studying traumatic events but also of focusing on the early familial and social environment in childhood stress research and indicated the importance of recording or monitoring childhood adversities.

     

Household crowding and psychosocial health among Inuit in Greenland

Objectives

Poor housing conditions experienced by many Indigenous peoples threaten their health and well-being. This study examines whether household crowding is associated with poorer psychosocial health among Greenlanders, and the mediating role of social support. It also assesses whether Inuit men and women are differently influenced by their housing conditions.

Methods

Data on more than 3,000 Inuit aged 18 years and older are from the Inuit health in transition Greenland survey. Associations between household crowding and composition, and mental well-being and binge drinking were examined using logistic regression models, adjusting for individuals’ characteristics.

Results

Household crowding was associated with poorer mental well-being. Binge drinking was more common among people living in households without children. These effects were more important for women than for men. The association between household crowding and mental well-being was significantly mediated by social support. This suggests that having a strong social network may buffer the deleterious impacts of household crowding.

Conclusions

Targeting housing conditions and fostering social support as part of population health interventions might contribute to improving psychosocial health and well-being in Greenland.     

On the associations between physical activity and quality of life: findings from an Australian nationally representative panel survey

Purpose

The purpose of this study is to provide a comprehensive analysis of the associations between the frequency of moderate or vigorous physical activity (MVPA) and quality of life (QoL) measures using longitudinal data and panel regression models on a large, representative sample of the Australian population.

Methods

This study used yearly panel data on over 23,000 individuals collected by the Household, Income and Labour Dynamics in Australia Survey between 2001 and 2011. Ordinary least squares and fixed effects regression models were used to examine the associations between the weekly frequency of MVPA and several indicators of QoL, including both measures of health-related QoL (such as those derivable from the SF-36) and global subjective well-being assessments (such as self-reported life satisfaction), controlling for observable and unobservable factors.

Results

Our results provided consistent evidence that the frequency of MVPA is related to QoL and proved to be robust. A higher frequency of MVPA was related to higher scores in each of the outcomes analysed and using either of two different estimation strategies. The most pronounced associations emerged between the frequency of MVPA and the physical and vitality dimensions of the SF-36. A change from undertaking no MVPA at all to undertaking such activity once a week was remarkably associated with higher QoL. The influence of MVPA on global life satisfaction was only partially channelled through physical and mental health.

Conclusion

We provide strong evidence that MVPA is related to QoL, thus adding to the large body of scientific literature demonstrating the benefits of becoming physically active.     

From well-being to positive mental health: conceptualization and qualitative development of an instrument in Singapore

Purpose

There is no global definition of well-being. Cultural differences in the perception of well-being and the social and behavioral contexts further limit its measurement. Existing instruments are developed in Western societies that differ in their conceptualization of well-being from Asian populations. Moreover, very few instruments address the multidimensional construct of well-being.

Methods

Literature was reviewed to develop a priori conceptual framework of mental health and well-being. Concepts were identified based on specific criteria to guide the qualitative investigations. Finally, focus group discussions were conducted among adults belonging to the three major ethnicities in Singapore to identify salient domains of mental health and well-being.

Results

Mental well-being is a multidimensional construct constituting of positive affect, satisfaction, and psychological functioning. While well-being explains the functional and psychological components, positive mental health is a combination of these and the skills required to achieve them. Although there is an overlap between the concepts identified from the literature and those identified in Singapore, certain differences existed, particularly with the relevance attributed to family interactions and religiosity or spirituality. Similar findings were observed across the three ethnic groups.

Conclusion

Domains identified can be used to develop a culturally relevant instrument in Singapore.