Caregiver Responsiveness to the Family Bereavement Program: What Predicts Responsiveness? What Does Responsiveness Predict?

The study developed a multidimensional measure to assess participant responsiveness to a preventive intervention and applied this measure to study how participant baseline characteristics predict responsiveness and how responsiveness predicts program outcomes. The study was conducted with caregivers who participated in the parenting-focused component of the Family Bereavement Program (FBP), a prevention program for families that have experienced parental death. The sample consisted of 89 caregivers assigned to the intervention condition in the efficacy trial of the FBP. Positive parenting, caregiver depression, and child externalizing problems at baseline were found to predict caregivers' use of program skills outside the group, and more child internalizing problems predicted more positive perceptions of the group environment. Higher levels of skill use during the program predicted increased positive parenting at the 11-month follow-up, whereas positive perceptions of the group environment predicted decreased caregiver depressive symptoms at follow-up. Caregiver skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up, and skill use and perceived group environment mediated changes in caregiver depression from baseline to 11-month follow-up.     

Do mental health and behavioural problems of early menarche persist into late adolescence? A three year follow-up study among adolescent girls in Oslo,Norway

Early menarche has been linked to mental health and behavioural problems in several studies. Most of these studies are cross-sectional, the data gathered during puberty. Thus, there is a lack of research on the long-term effect of early menarche on mental health. The main aim of this study was to explore whether the differences in mental health problems between girls with early and late menarche persist into late adolescence. The data consisted of responses from a large school-based survey of all 10th grade girls (15 years of age) in Oslo, Norway. Of the 1860 participating girls in the 2001 survey, 1377 were included in the three year follow-up study in 2004, giving a response rate of 74%. Mental distress was measured with the Hopkins Symptom Check list 10-version. Additional items assessed were number of sexual partners, weight and body satisfaction. All information was self-reported, including age of menarche. We found a clear gradient in the cross sectional analyses at baseline of higher odds for mental distress at lower age of menarche even after adjustment for socio demographic and other factors. In the analysis of the follow-up data there was no statistically significant difference in mental distress across age of menarche, even though the differences in body and weight satisfaction and average body mass index remained at the same level between baseline and follow-up. We therefore conclude that the effects of age of menarche on mental health problems are a transitory problem during puberty.     

大学生心理健康发展与领悟社会支持的关系

探索大学生心理健康状况的动态发展规律及领悟社会支持的影响,为制定更有针对性的保护大学生心理健康的措施提供参考.方法 采用整群抽样的方法,使用大学生人格问卷(University Personality Inventory,UPI)和领悟社会支持量表(Perceived Social Support Scale,PSSS)对广州某高校2014年入学的2 301名大学生进行追踪研究.2次施测的时间分别是2014年9月23日和2016年9月25日.结果 大三时学生的UPI得分(9.18±8.49)低于大一(10.11±7.87)(t=29.90,P<0.01).大三时学生严重心理问题的人数比例比大一上升1.0百分点,一般心理问题的人数比例下降1.7百分点,心理健康的人数比例上升0.7百分点(x2=377.59,P<0.01).女生UPI得分(10.09±8.32)高于男生(8.81±7.91)(t=17.13,P<0.01).领悟社会支持水平越高,UPI得分越低(F=149.65,P<0.01).大一时学生UPI为A类(严重心理问题)且低领悟社会支持的大三UPI得分最高,大一UPI为C类(心理健康)且高领悟社会支持的大三UPI得分最低;高领悟社会支持条件下,大一UPI A/B(一般心理问题)/C类的学生大三UPI得分均低于低领悟社会支持条件下的学生.结论 大学生入校后,心理健康状况呈2个动态两极化的趋势发展.领悟社会支持能力对大学生心理健康动态发展具有持续性的调节作用.     

The Relationship Between Substance Use and Sexual Health Among African-American Female Adolescents with a History of Seeking Mental Health Services

BackgroundThis study examined relationships between substance use patterns and problems and sexual health outcomes among low-income, urban, African-American female adolescents with a history of seeking mental health services.MethodsParticipants were recruited from outpatient mental health clinics serving urban, primarily low-income youth and families in Chicago, Illinois, as part of a 2-year, longitudinal investigation of HIV risk behavior during which they completed interviews every 6 months (five time points). Girls who completed at least one follow-up interview were invited to participate in a sixth wave of assessment to assess trauma exposure, substance use problems, and sexual risk. The current study (n = 177) examined the association between sexual risk behavior and substance use problems reported at the most recent interview (ages 14–22) and substance use patterns and sexually transmitted infections (STI) reported at all six times points. Multiple regression examined the combined and unique effects of different patterns of substance use and substance use problems as correlates of sexual risk behavior and STIs.FindingsSubstance use problems were associated with increased sexual risk behavior and increased likelihood of experiencing STIs. Substance use patterns were associated with sexual risk behavior.ConclusionsResults suggest that specific patterns of substance use and substance use problems are important to address in sexual health promotion among low-income, urban, African-American girls with a history of seeking mental health services. Understanding the nuances of these relationships is important in informing how to best serve this vulnerable group of adolescents who experience significant sexual risk and mental health care disparities.     

Public drug insurance,moral hazard and children's use of mental health medication: Latent mental health risk-specific responses to lower out-of-pocket treatment costs

Studies have shown that reducing out-of-pocket costs can lead to higher medication initiation rates in childhood. Whether the cost of such initiatives is inflated by moral hazard issues remains a question of concern. This paper looks to the implementation of a public drug insurance program in Québec, Canada, to investigate potential low-benefit consumption in children. Using a nationally representative longitudinal sample, we harness machine learning techniques to predict a child's risk of developing a mental health disorder. Using difference-in-differences analyses, we then assess the impact of the drug program on children's mental health medication uptake across the distribution of predicted mental health risk. Beyond showing that eliminating out-of-pocket costs led to a 3 percentage point increase in mental health drug uptake, we show that demand responses are concentrated in the top two deciles of risk for developing mental health disorders. These higher-risk children increase take-up of mental health drugs by 7–8 percentage points. We find even stronger effects for stimulants (8–11 percentage point increases among the highest risk children). Our results suggest that reductions in out-of-pocket costs could achieve better uptake of mental health medications, without inducing substantial low-benefit care among lower-risk children.     

Preventing Drug Abuse Among Adolescent Girls: Outcome Data from an Internet-Based Intervention

This study developed and tested an Internet-based gender-specific drug abuse prevention program for adolescent girls. A sample of seventh, eighth, and ninth grade girls (N = 236) from 42 states and 4 Canadian provinces were randomly assigned to an intervention or control group. All girls completed an online pretest battery. Following pretest, intervention girls interacted with a 12-session, Internet-based gender-specific drug prevention program. Girls in both groups completed the measurement battery at posttest and 6-month follow-up. Analysis of posttest scores revealed no differences between groups for 30-day reports of alcohol, marijuana, poly drug use, or total substance use (alcohol and drugs). At 6-month follow-up, between-group effects were found on measures of 30-day alcohol use, marijuana use, poly drug use, and total substance use. Relative to girls in the control group, girls exposed to the Internet-based intervention reported lower rates of use for these substances. Moreover, girls receiving the intervention achieved gains over girls in the control group on normative beliefs and self-efficacy at posttest and 6-month follow-up, respectively.     

The Pennsylvania domiciliary care experiment: I. Impact on quality of life.

This paper reports findings concerning the impact on quality of life of a case management focused program of small board and care facilities serving aging, mental health, and mental retardation adult target populations--the Pennsylvania Domiciliary Care Program. Program participants from the counties in which the Domiciliary Care Program was initiated were matched with persons residing in similar counties without the program who were comparable on a large array of characteristics prior to program initiation. Conducted separately by target group, 10-month follow-up assessments provided the basis for determining impact. In general, the effects were positive, particularly with respect to meeting program quality of life goals (providing needed services, improving living conditions, increasing community integration, and reducing institutional days); the effects were more positive for the aging and mental health than for the mentally retarded target populations.     

Three-year follow-up on the effects of a smoking prevention program for elementary school children with a quasi-experimental design in Japan

OBJECTIVE: We performed the follow-up tests for three years for junior high school students by the quasi-experimental design to investigate the medium-term effect of smoking prevention education in the elementary school. METHODS: The intervention group consisted of 106 school students of three elementary schools and received a smoking prevention program in the elementary school. Moreover, the follow-up tests were conducted at each grade of junior high school, and the booster program was mailed. The comparison group consisted of 193 school students of another three elementary schools without the program. RESULTS: The intervention effects were recognized on knowledge up to the second grade of junior high school for boys and up to the third grade for girls, on awareness of the importance of not smoking at the second grade, and on the intention of smoking at the age of 20 for girls up to the first grade. On the other hand, the intervention effects were not recognized on smoking experience for boys and girls. However, increase of the rate of smoking experience was not significant in the intervention group, while it was significant in the comparison group. CONCLUSION: The effect of the program for three years was judged to be moderate.     

Twelve-Month Outcomes of a Randomized Trial of the Positive Thoughts and Action Program for Depression Among Early Adolescents

This study was conducted to examine the 12-month effects on depression and depressive symptoms of a group-based cognitive-behavioral preventive intervention for middle school students (Positive Thoughts and Actions, or PTA), relative to a brief, individually administered supportive intervention (Individual Support Program, or ISP). A randomized clinical trial was conducted with 120 early adolescents (73 girls and 47 boys; age 12–14 years) drawn from a school-based population who had elevated depressive symptoms. Youths completed measures of depressive symptoms at baseline, post-intervention, and 6 and 12 months into the follow-up phase. Measures of internalizing problems, externalizing problems, school adjustment, interpersonal relationships, and health behavior were obtained from parents and/or youth. Multilevel models indicated that the effect of PTA on youth-reported depressive symptoms persisted until 12-month follow-up; d?=?0.36 at post-intervention, d?=?0.24 at 6-month follow-up, and d?=?0.21 at 12-month follow-up. PTA youths also reported lower internalizing symptoms at post-intervention, d?=?0.44, and at 12-month follow-up, d?=?0.39. Time-limited effects were found for parent-reported internalizing symptoms and health behavior. Onset of new depressive episodes did not differ based on intervention group (21 % ISP; 17 % PTA). Results demonstrate support for the long-term efficacy of PTA, a cognitive-behavioral preventive intervention in which youths engage in personal goal-setting and practice social-emotional skills.     

The Impact of a Family-Based Economic Intervention on the Mental Health of HIV-Infected Adolescents in Uganda: Results From Suubi + Adherence

PurposeThis study examines the extent to which three mental health measures (hopelessness, depression, and poor self-concept) are improved through a family-based economic intervention implemented among adolescents living with HIV in Uganda.MethodsWe used repeated measures from Suubi + Adherence, a large-scale 6-year (2012–2018) longitudinal randomized controlled trial. Bivariate analyses were conducted to test for observable group differences between the intervention and control conditions. Multilevel piecewise repeated measure mixed models were then conducted to assess hypothesized time × intervention interaction in changes in hopelessness, depression, and self-concept using participant-specific follow-up intervals.ResultsAt 24-month postintervention initiation, adolescents in the intervention condition reported a statistically significant lower hopelessness score than adolescents in the control condition (4.79 vs. 5.56; p = .018; N = 358). At 36-month follow-up, the intervention condition reported a statistically significant lower score on depression in the depression subgroup (N = 344) than the control condition (4.94 vs. 5.81; p = .029).ConclusionsThe results indicate that family-based economic interventions such as Suubi + Adherence can effectively improve the mental health of adolescents living with HIV who evidenced mental health challenges at baseline. Given the promising positive effects of these interventions, at least in the short term, future studies should investigate strategies to promote the sustainability of these mental health benefits.     

Moving to Opportunity: Does long-term exposure to ‘low-poverty’ neighborhoods make a difference for adolescents?

This study re-analyzed data on adolescent health outcomes (N = 1780; M age = 15.15, SD = 2.30) from a 5-year evaluation of the Moving to Opportunity (MTO) Program. The MTO program is a randomized experiment conducted in five cities in the United States (Baltimore, Boston, Chicago, Los Angeles and New York) in which low-income families living in public housing in 'high-poverty' neighborhoods were offered vouchers and assistance to move to 'low-poverty' neighborhoods. The objective was to reexamine program effects as a function of exposure to 'low-poverty' neighborhoods to determine whether beneficial effects reported for girls' mental health and behavior generalized to other outcomes for girls and to boys. As found in previous evaluations, girls in the MTO program group, whose families remained in 'low-poverty' neighborhoods for comparatively long periods (approximately 5 years), had better mental health and engaged in fewer risky behaviors than a matched control sample of girls, whose families stayed in 'high-poverty' neighborhoods. Further, additional benefits for girls were seen in the education domain. Adverse program effects on boys' behavior problems, reported in other MTO research using different methods, were not evident in our analysis. Findings suggest that programs relocating low-income families to 'low-poverty' neighborhoods should provide supports to families and to receiving communities to promote residential stability and social integration.     

Psychological distress among older adolescents and young adults in Australia

Abstract: Youth mental health has been specially targeted in the National Health Goals and Targets process for mental health. The incidence of suicide among Australia's youth is one of the highest in the world. Yet there is little information on the mental health of young people in Australia. The most recent national data come from the longitudinal Australian Youth Survey conducted by the Department of Education, Employment and Training. In the 1994 wave of the survey, 8350 adolescents and young adults aged between 16 and 24 were surveyed. Psychological distress was measured by the 12-item General Health Questionnaire (GHQ). High levels of psychological distress were evident, with girls being more distressed than boys at all ages. Forty-one per cent of girls were classified by the GHQ as mild or moderate cases, compared with 26 per cent of boys. Levels of distress peaked at age 17 for both boys and girls and tended to decrease with age for girls, but to be relatively stable over time for boys.     

The effects of planned duration of residential drug abuse treatment on recovery and HIV risk behavior.

OBJECTIVE: This study assessed the effects of planned duration of residential drug abuse treatment on recovery from drug use and on human immunodeficiency virus (HIV) risk behaviors. METHODS: Two concurrent randomized controlled trials of programs differing in planned duration were conducted: 6-month vs 12-month versions of a traditional therapeutic community program, and 3-month vs 6-month versions of a modified therapeutic community incorporating a relapse prevention and health education program. Outcomes, measured at least 16.5 months after admission, included time from admission to first drug use; severity of drug, alcohol, legal, and employment problems; and risky drug injection and sexual behaviors. RESULTS: Among 539 clients (86% of those enrolled), there were no significant effects of planned duration of treatment upon Addiction Severity Index scores or HIV risk behavior. In the relapse prevention program, clients randomized to the 6-month program had a longer time to first drug use than those in the 3-month program (hazard ratio = 0.74; 95% confidence interval = 0.58, 0.93). Employment problems at follow-up were significantly less severe among clients treated in the therapeutic community than among those in the relapse prevention program. CONCLUSIONS: No overall benefit of extending treatment beyond 6 months was found.     

Longitudinal effects of integrated treatment on alcohol use for persons with serious mental illness and substance use disorders

A randomized experimental design was used to assign participants to an integrated mental health and substance use treatment program or to standard hospital treatment. A multilevel, nonlinear model was used to estimate hospital treatment effects on days of alcohol use for persons with serious mental illness and substance use disorders over 18 months. The integrated treatment program had a significant effect on the rate of alcohol use at 2 months postdischarge, reducing the rate of use by 54%. Motivation for sobriety at hospital discharge, posttreatment self-help attendance, and social support for sobriety were also found to reduce the rate of use during the follow-up period. Implications for mental health treatment and aftercare support are discussed.     

大学生新冠肺炎疫情风险感知与体育锻炼及心理健康的关系

  目的  了解大学生新冠肺炎疫情风险感知、体育锻炼与心理健康的内在机制,为有效缓解常态化疫情防控背景下大学生心理健康问题提供理论依据。  方法  采用纵向设计,使用心理症状自评量表(SCL-90)、体育锻炼等级量表(PARS-3)、新冠肺炎疫情风险感知量表分别于2021年12月(T1)和2022年3月(T2)方便抽取郑州、北京、沈阳、天津4个地区16所高校的973名大学生进行2次追踪调查。  结果  2次调查,男、女生在新冠肺炎疫情风险感知变量上差异无统计学意义(Z值分别为-1.81,-1.82,P值均>0.05),在体育锻炼和心理健康2个变量上存在跨群组的性别差异(T1:Z值分别为-0.98,-4.84;T2:Z值分别为-0.86,-4.64,P值均＜0.01),男生的体育锻炼和心理健康状况优于女生;大学生在新冠肺炎疫情风险感知、体育锻炼与心理健康上存在稳定、同步相关性(r=-0.31~0.54,P值均＜0.01);大学生新冠肺炎疫情风险感知T1能够预测体育锻炼和心理健康T2(β值分别为0.30,0.43,P值均＜0.01),体育锻炼T1能够预测心理健康T2(β=0.37,P＜0.01),且在新冠肺炎疫情风险感知与心理健康的影响路径上,体育锻炼具备中介作用。  结论  新冠肺炎疫情风险感知、体育锻炼与心理健康存在纵向因果关系,依据性别提高大学体育锻炼意识对改善心理健康具有现实意义。     

Eating disturbances among adolescent girls: Evaluation of a school-based primary prevention program

A school-based program aimed at the primary prevention of eating disturbances was developed, implemented, and evaluated. The eating disturbances targeted included unhealthy dieting and binge-eating, which are common among nonclinical populations of adolescent girls. The program was based on social-cognitive principles for behavioral change, and the goals were to change knowledge, attitudes, and behaviors related to nutrition and weight control; improve body and self-image; and promote greater self-efficacy in dealing with social pressures regarding excessive eating and dieting. The baseline population included 341 tenth-grade girls from 16 classes at three high schools in Jerusalem. Classes were assigned to intervention or control groups and girls in the former participated in a 10-session program. Program effectiveness was evaluated with a quasi-experimental design for 269 girls who were present at follow-up assessments conducted both 6 months and 2 years after program implementation. Results indicated that the program had moderate effects on nutrition knowledge and meal patterns and on preventing the. onset of unhealthy dieting and bingeing behaviors. The effects were most consistent among overweight girls. The results suggest that school-based programs can contribute to primary prevention of eating disturbances.     

Psychische Gesundheit von übergewichtigen und adipösen Jugendlichen unter Berücksichtigung von Sozialstatus und Schulbildung

Background

International studies showed that overweight and obese adolescents are more likely to have mental health problems compared to normal weight peers.

Objectives

This study analyses the relation between overweight/obesity and mental health problems among adolescents in Germany as well as potential modifying factors of this relation.

Materials and Methods

Data base was a subsample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, n?=?6,813, 11–17 years) which was conducted by the Robert Koch Institute from May 2003 to May 2006. Body height and weight were measured in a standardised manner and body mass index (BMI) was calculated. Indications of mental health problems and strengths were collected with the Strengths and Difficulties Questionnaire (SDQ) in the following areas: emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial behaviour. Socio-economic status (SES) and education are analysed as modifying variables. Prevalence and odds ratios with 95?% confidence intervals were calculated by binary logistic regression.

Results

Obese boys and overweight and obese girls showed more indications of mental health problems compared to normal weight peers. The most common problem areas were conduct problems and peer relationship problems. Obese girls were also more likely to show indications of emotional symptoms compared to normal weight girls. The age stratified analysis showed that the differences in the occourrence of mental health problems between normal weight and obese boys as well as between normal weight and overweight/obese girls are more pronounced aged 11 to 13 years than aged 14 to 17 years. The results on the impact of SES and education showed that in girls, SES had a modyfying impact on the relation between overweight/obesity and mental health problems in favour of the high SES group. In boys, SES only had a modifying impact on the relation between overweight and mental health problems, but here in favour of the low SES group. Only in girls education had a modifying impact on the relation between obesity and mental health problems in favour of the low education group.

Conclusion

In adolescence, overweight and especially obesity go along with a higher risk for mental health problems. In the context of prevention measures and care services for overweight and obesity at a young age, psychosocial aspects should be considered.     

Weight Control in Adolescent Girls: A Comparison of the Effectiveness of Three Approaches to Follow-up

The purpose of the project was to compare the effectiveness of three different types of follow-up of a weight control program in assisting adolescent girls to achieve and maintain ideal body weight. During the initial phase of the weight control program, subjects attended two sessions of approximately one hour each for eight weeks. One session each week included theory and practice of physical exercise. The other session was devoted to behavioral control of eating and diet therapy. After eight weeks, 18 subjects were divided randomly into three groups for follow-up: Group 1 — monthly measurements and reinforcement of behavioral, diet, and exercise components of the weight control program; Group 2 — monthly measurements; and Group 3 — annual measurements. Fifteen subjects completed the 12-month follow-up program. Mean weight loss during follow-up of Group 1 was 3.65 kg, Group 2 was 1.90 kg, while Group 3 had a mean weight gain of 3.44 kg. The results suggest that regular follow-up may be a critical element in successful weight control programs for adolescent girls.     

The Effects of Mental Health Factors on Ambulatory Care Visits by Rural Teens

This study sought to determine the effects of mental health variables on rural adolescents' use of ambulatory health care services and whether these effects varied across common outpatient settings. Using a cross-sectional survey design, 2,297 adolescents who attended public schools in grades 7 through 12 in one isolated rural Mississippi River Delta county were assessed via a standardized health behavior survey. This self-report measure inquired about relevant health behaviors such as alcohol use, depressive symptoms, and health service use. The students' mean age was 15 years and 58 percent of the sample were black. Approximately 11 percent of the sample reported symptoms of depression, 16.5 percent reported problem drinking, and slightly fewer than 6 percent reported both. After controlling for predisposing, enabling, and need factors, the reporting of depressive symptoms, problem drinking, or both was related to an increased number of outpatient visits in three of four sites examined. However, differences among sites were observed. These data suggest that mental health problems are associated with increased visits to ambulatory settings, and these problems affect service use differentially. Thus, effective interventions and better linkages between ambulatory settings and mental health providers may reduce unnecessary use.     

Impact of organisational change on mental health: a systematic review

Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.