The American journal of orthopsychiatry最新文献

Children and young people in out-of-home care are at a higher risk of suicide than young people not involved with child protection systems. Despite this, there is a lack of evidence of effective suicide prevention interventions for this vulnerable population. We reviewed the types of suicide prevention interventions that have been used and evaluated with children and young people and staff and carers in out-of-home care/child protection systems. We conducted a systematic review of existing literature using PRISMA guidelines. Only five studies met the inclusion criteria. Two evaluated youth-focused interventions: emotional intelligence therapy; and multidimensional treatment foster care, while three evaluated adult-focused "gatekeeper training." Youth-focused interventions led to reductions in suicidal thoughts (suicidal ideation), and adult-focused interventions led to increased knowledge, skills, and behaviors such as referring youth to supports. Only one study, one of the youth-focused ones, evaluated the impact of the intervention in terms of suicide attempts but found no reduction. Large numbers of children enter into care with a high risk of suicide. With the considerable overlap between the trauma characteristics and mental health needs of young people in out-of-home care and suicide risk factors in the general population of young people, we recommend developing (and evaluating) new or adapted existing suicide prevention interventions designed specifically for the out-of-home care context. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Kurds have a long history of victimization and struggle for even the most basic rights. This is reflected in a widely shared belief, according to which they have "no friends but the mountains." Such difficult history may have ongoing negative impact on mental health of present-day Kurds. This article investigates the relations between cognitive availability of historical trauma, historical trauma symptoms, and negative mental health outcomes in a sample of young Kurds who live in the Region of Kurdistan in Iraq. We also examined the potential protective role of strong identification as members of a national minority (Iraqi Kurds) and as members of an ethnic group (Kurdish people in general). The results showed that tragic group history is significantly related to negative mental health outcomes among young Iraqi Kurds. However, strong identification with other Iraqi Kurds (but not with Kurds in general) had an attenuating effect on the link between historical trauma and present-day negative mental health outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In the United States, Muslims have increasingly been the targets of discrimination. While prior research suggests that increased perceived discrimination is associated with elevated depression and anxiety symptoms in this population, no existing studies have explored whether this relationship is mediated by acculturative stress, and few have examined potential moderating factors. This study aimed to investigate whether acculturative stress mediates the relationship between perceived discrimination and depression and anxiety symptoms, as well as examine the moderating roles of Muslim identity and religious support. Participants included 205 Muslim college students, who completed an online survey. Findings revealed that the indirect effect of perceived discrimination on depression and anxiety symptoms via acculturative stress was statistically significant. In addition, religious support emerged as a significant moderator, with higher levels of religious support increasing the strength of the indirect effect on depression and anxiety symptoms. The results suggest clinicians and higher education staff working with Muslim college students should assess for perceptions of discrimination and acculturative stress, as well as examine the role that religious support plays in that individual's life. Future research should examine how discrimination, acculturative stress, and involvement in one's religious congregation affect mental health outcomes, as well as investigate whether these findings are generalizable to other religions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective: Guided by a resilience framework, this study examines the accumulation of risk and protective factors, as well as the potential buffering effects of protective factors on mental distress among female military spouses.

Background: Most research with this population has focused on individual risk factors affecting military spouses. Less frequently have the effects of cumulative risk, risk factors not specifically associated with military service, or protective factors been examined, though there is evidence for their importance.

Method: This study used secondary survey data from 334 female Army spouses collected in 2012 as part of the Land Combat Study 2. Cumulative risk and protective factor scores as well as scores within risk (intrapersonal, family, and military-specific) and protective (individual and environmental) factor domains were calculated. Four structural equation models were run to examine main and interaction effects on mental distress, a latent variable representing depression, anxiety, and trauma symptoms.

Results: In cumulative risk and protective factor models, cumulative risk was directly, positively associated with mental distress. This relationship was moderated by cumulative protection. In domain-specific models, only family risk was directly associated with mental distress. This relationship was moderated by environmental protective factors.

Conclusion: Findings indicate mental distress among military spouses is associated with exposure to cumulative risk and attenuated by the presence of certain domains of protective factors. Family risk factors including marital distress and work-family conflict may be particularly pernicious stressors, but informal and structural supports may be important targets for prevention and intervention efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Consensus reports have called for interventions to educate civilians about the reintegration challenges that veterans experience. The current study describes veterans' perspectives of what the public should know and what the public can do to help veterans reintegrate into civilian life. We conducted thematic analysis of written essays from a stratified random sample of 100 US veterans (half women, half deployed from National Guard or Reserves) from Afghanistan and Iraq military operations who had participated in the control writing condition from a randomized controlled trial of expressive writing to improve reintegration outcomes. Veterans described a military-civilian divide that makes reintegration difficult and recommended that the public help bridge this divide. The divide was attributable to the uniqueness of military culture and bonds, the personal changes associated with deployment, and the time it takes for veterans to reacclimate. Five themes captured what the public can do to foster veteran reintegration: understand deployment hardships; appreciate deployment accomplishments; assist veterans in getting professional help; listen, don't judge; and recognize that employment is critical to reintegration. Themes were present across groupings by gender, type of military service and screening status for posttraumatic stress disorder. Findings can inform interventions that target the public's understanding of and response to returning veteran. Consistent with an ecological model of reintegration, such interventions have the potential to foster successful reintegration. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Despite growing recognition of the links between poverty and child maltreatment, little is known about the specific practices and strategies utilized to directly respond to families' poverty. One such practice is the provision of material assistance, which is widespread in child protection settings but has received negligible scholarly attention. The article aims to describe and conceptualize this underresearched practice and to explore the challenges workers face when implementing it. The study described here included 20 in-depth interviews conducted with social workers working in an innovative Israeli child protection program called Families on the Path to Growth. The program is based on the Poverty-Aware paradigm and provides social workers and families with a substantial flexible budget designated for families' needs. Findings revealed that utilizing material assistance is an extremely complex and multidimensional task. Specifically, workers' engagement with this practice revolved around three continuums that range between (a) collaboration and countercollaboration; (b) splitting and integrating the emotional and the material; and (c) a hermeneutic of trust and a hermeneutic of suspicion. In the discussion, we explore the findings in relation to Nancy Fraser's conceptualization of social justice, redistribution, and recognition. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Although neighborhood context is a well-recognized factor in the well-being of children and families, little systematic research exists to guide inquiries into the intersection of neighborhood social processes and child and family well-being. Moreover, despite the increased popularity of neighborhood effects research over the last several decades, crucial questions around the debate on how to align research findings with tangible experiences for children and families remain open. This article reviews selected studies that linked neighborhood factors to specific domains of child and family well-being: parenting, safety, health, and educational outcomes. By focusing on neighborliness, a particular form of neighboring, the study aims to shift the focus from macrolevel indicators of neighborhood context, to a more dynamic set of attributes that characterize neighborhood life, with the hope of inspiring others to build upon the findings and begin to translate the conclusions to meaningful policies and programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adverse childhood experiences and other potentially traumatic events have lasting implications for mental health. Evidence-based treatments are available to address trauma-related symptoms, but their impact is hindered because access is limited and unequal. In the U.S., adverse experiences and mental disorders disproportionately affect socioeconomically disadvantaged groups that face treatment access barriers-disparities that are compounded by passive systems of care that wait for clients to seek treatment. This article presents a conceptual argument, backed by empirical evidence, that population health can be improved by implementing trauma-responsive practices, and that greater mental health equity can be achieved if these strategies are used to engage underserved clients. A description is provided of the Trauma Screening, Brief Intervention, and Referral to Treatment (T-SBIRT), a promising protocol that can be used by nonclinical providers to detect trauma-related mental health concerns in adults and help them access therapeutic services. The T-SBIRT protocol has been successfully implemented in diverse settings, and it is currently being piloted in a universal postpartum home visiting program called Family Connects. Prior results from three trials of Family Connects are summarized, including evidence of program impact on maternal mental health. New results are also presented indicating that T-SBIRT is feasible to implement within Family Connects, as denoted by indicators of suitability, tolerability, provider adherence, and referral acceptance. Closing recommendations are offered for reducing mental health disparities by testing and disseminating T-SBIRT through Family Connects and other large-scale programs and systems of care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background: There is limited understanding of the prevalence of psychological distress and associated stressors and supports among displaced adults in low- and middle-income first asylum countries.

Method: This article reports the findings of a cross-sectional study. We recruited 245 Congolese adults (18-80 years) residing in Nairobi, Kenya using snowball sampling. Data were collected using an interviewer-administered questionnaire consisting of sociodemographic characteristics, the Self-Reporting Questionnaire (SRQ-20), and a locally developed stressors and supports survey. We used multivariable logistic regression to examine associations among sociodemographic, stressor, and support variables and the likelihood of experiencing psychological distress.

Results: More than half of the participants (52.8%) reported symptoms indicative of psychological distress. Factors associated with increased psychological distress included perceiving to have a useful role in one's family or community, AOR = 1.85; 95% CI [1.1.17, 3.11], p = .012, feeling confused or not knowing what to do, AOR = 2.13; 95% CI [1.20, 4.6], p = .014, and feeling afraid to leave home for medical/health care to help with an illness, AOR = 1.57; 95% CI [1.17, 2.15], p < .01. Additionally, ethnic Banyamulenge Congolese adults without legal refugee status had an increased likelihood of experiencing psychological distress, AOR = .07; 95% CI [0, .74], p = .035.

Conclusion: Future research is warranted to understand how to implement targeted mental health and psychosocial support (MHPSS) to improve urban-displaced adults' sense of safety and belonging. Our findings suggest that legal refugee status is an important structural determinant of mental health, which should be considered in MHPSS practice and policy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The U.S. annual rate of child maltreatment reports has increased from 38.9 per 1,000 children in 2007 to 47.8 per 1,000 children in 2018 (U.S. Department of Health & Human Services, 2012, 2020). Using national administrative child welfare data from the National Child Abuse and Neglect Data System, the present study examined longitudinal trends in child maltreatment reports over the years 2007-2018. Specifically, the following research questions were examined: (a) Do upward trends in child maltreatment reports differ by the source of the report (i.e., professional or nonprofessional sources) and between urban and rural areas?; (b) Do increasing numbers of child maltreatment reports represent reports with a low risk of recidivism (i.e., re-reporting)?; and (c) Do longitudinal trends of Child Protective Services (CPS) responses to investigated reports differ by the source of the report and between urban and rural areas? We found that increases in maltreatment reports were primarily driven by increases in reports from professional sources and that report rates increased across rural and urban areas alike. However, the increases were more significant in rural and small urban areas compared to large urban areas. We did not find evidence that the increasing numbers of reports were due to an increase in reports with low recidivism risk. (PsycInfo Database Record (c) 2021 APA, all rights reserved).