The American journal of orthopsychiatry最新文献

Purpose: North American Indigenous (NAI) communities often cite substance misuse as problematic in their communities. The Competing Life Reinforcers (CLRs) model suggests that when reinforcers are valued, important, and incompatible with substance use, they will be associated with less substance misuse. Three categories of CLRs were identified in our formative work and include the following: cultural, social, and extracurricular activities. The aims of the current study were to test the associations among valuing and availability of CLRs and NAI adolescent alcohol and marijuana use.

Methods: Adolescents living in rural First Nation reserve communities (N = 106, 50.0% female) reported their substance use and perceived availability and valuing of CLRs (e.g., smudging and after school activities).

Findings: Greater value placed on cultural reinforcers was significantly associated with reduced likelihood of past 3-month drinking to get drunk (OR = 0.85, 95% CI[0.73, 0.98]). Greater value placed on social reinforcers was associated with lower likelihood of past 3-month drinking (OR = 0.94, 95% CI[0.89, 0.995]) and past-3 month drinking to get drunk (OR = 0.94, 95% CI[0.88, 0.99]). Greater valuing extracurricular activities were associated with lower likelihood of past month marijuana use (OR = 0.84, 95% CI[0.72, 098]), past 3-month drinking (OR = 0.77, 95% CI[0.64, 0.92]), and past 3-month drinking to get drunk (OR = 0.76, 95% CI[0.63, 0.92]).

Conclusions: CLRs may be protective against NAI adolescent substance use and may be useful targets for prevention and treatment for NAI adolescent substance use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The main objective of this research is to examine the consequences of perceived discrimination in family caregivers of people with physical disabilities. Through path analysis, we test the association between caregivers' perceived discrimination and their anxiety and depression and the mediating role that affiliate stigma and self-efficacy may play. We proposed a model that has not been tested previously in the literature on caregivers of people with physical disabilities. The sample includes 186 Spanish fathers (35%) or mothers (65%) raising children with physical disabilities. Descriptive statistics and Pearson's correlation coefficients were calculated and structural equation modeling was used to examine the mediating effect. Results show that caregivers' perceived discrimination is positively associated with their affiliate or internalized stigma that in turn is harmful to their anxiety and depression. However, caregivers' self-efficacy plays a mediating role in the relation between affiliate stigma and caregivers' anxiety and depression. These results may be useful for designing interventions to improve the psychological well-being of the parents of children with physical disabilities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Following deinstitutionalization, services and housing for people with serious mental illnesses (SMI) became concentrated in economically disadvantaged urban centers. As these areas gentrify, affordable housing for people with SMI is increasingly found in nonurban areas. Although nonurban environments provide benefits for the general population, people with SMI living in nonurban areas perceive higher levels of mental illness stigma. Thus, the relationship between perceived stigma and negative outcomes such as high psychological distress and low sense of community may be stronger in nonurban areas. Data collected from 300 adults with SMI living in urban and nonurban areas were analyzed using a moderated regression design. Urbanicity did not moderate the relationships between perceived stigma and negative outcomes. However, associations were found between urbanicity, perceived stigma, sense of community, and psychological distress, supporting the need to address mental illness stigma in all settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sibling victimization is associated with adjustment problems. Protective factors that reduce the detrimental effects of sibling victimization are unknown. We examined the mediating role of social support from family and friends in the relationship between sibling victimization and adolescents' mental health distress, self-esteem, and delinquency. A telephone survey (N = 850; 49% female) was conducted with a nationally representative sample of United States adolescents (Aged 10 to 17). Three mediation models were tested exploring (a) the unique effects of family and friend support, (b) the relative effects of each type of support, and (c) the effects of total support (family and friend support summed). The three models demonstrated partial mediation of adolescents' mental health and self-esteem. Family and total support, but not friend support, partially mediated the relationship between sibling victimization and delinquency. Findings showed that family and friend social support, in combination and sometimes uniquely, reduced the adverse effects sibling victimization associated with adolescents' mental health, self-esteem, and delinquency. Efforts aimed at promoting social support from family and friends as protective factors may reduce the risk of sibling victimization experiences for adolescent well-being difficulties. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Homeless people are one of the most obvious embodiments of the phenomenon of social exclusion, and homeless immigrants and homeless women are considered 2 particularly vulnerable groups. The objective of this article is to analyze the differences between women living homeless born in Spain (nonimmigrants) and those born abroad (immigrants). The study was carried out based on the data obtained from a sample of women living homeless in Madrid (Spain; N = 136). The information was collected using a structured interview. The results show major similarities between immigrant and nonimmigrant homeless women in terms of their basic sociodemographic characteristics (age, marital status, number of children), their state of health, satisfaction with their family and/or partner relationships, and feelings of loneliness or abandonment. Fewer immigrant women had their documentation in order, they received fewer financial benefits and their contact with their family of origin was more limited. However, the immigrant women became homeless at an older age and were subject to less chronic homelessness, their levels of consumption of alcohol and other psychoactive substances were lower, they had experienced fewer stressful life events, more of them had completed higher education, and more of them used mobile telephones and the Internet. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Low-income communities of color experience significant political, economic, and health inequities and, not unrelatedly, are disproportionately exposed to violent crime than are residents of higher income communities. In an effort to mitigate concentrations of poverty and crime, governmental agencies have partnered with affordable housing developers to redevelop public housing "projects" into mixed-income communities and to do so within a "trauma-informed" framework. The current study analyzes how residents have historically and contemporaneously negotiated, endured, and resisted structural and interpersonal violence in 2 long-standing, predominately African American, public housing communities undergoing a public-private housing redevelopment initiative. Interviews with 44 adult public housing residents (age range = 18-75 years; 82% African American/Black) were conducted during a 2-year period while residents' homes were being demolished and rebuilt into mixed-income communities. Analysis of in-depth interviews used constructivist grounded theory principles to reveal a common theme and basic social process of the ongoing formation of homeplace, with subthemes focusing on the ways homeplace emerges through shared lineage, knowing and caring practices; how homeplace is maintained through networks of protection in unsafe contexts; how homeplace is disrupted as a result of redevelopment activities; and the reclamation of homeplace during redevelopment in the service of hope and healing. These findings offer a nuanced view of resident's lived experiences of place-based trauma and collective resistance and resilience, while also highlighting the place-specific ways in which redevelopment unsettles deeply rooted sociocultural configurations of home and community. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Previous research has demonstrated that women who sell sex (women sex workers [WSWs]) consistently report high levels of posttraumatic stress symptoms. The present study explores multiple factors that may contribute to the variation in WSWs' experiences of posttraumatic stress symptoms, including workers' racial identity, experiences of discrimination and control over their working conditions, the site of selling sex, and their clients' perceived sexual entitlement and violence. The study sample consisted of 314 self-identified WSWs. Online invitations to participate in a 30-min survey were sent to WSWs in the United States and Canada who advertise their services online on sites such as Facebook, the Erotic Review, and Backpages. The hypothesized structure of associations between the variables was tested using structural equation modeling. The model accounted for 68% of the variation in the traumatic stress reported, with direct and indirect effects for workers' racial identity, the site where they sell sex, and experiences of discrimination, especially by police. Clients' violence, on the contrary, was indirectly associated with traumatic stress, as violent clients were also significantly more likely to be perceived as sexually entitled, which, in turn, was the strongest predictor of higher traumatic stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Health-care workers operating in conflict zones are at severe risk of psychological consequences, given their extended exposure to traumatic events under conditions of stress and violence. This quantitative, cross-sectional study was designed to explore the relationships between personal resources (sources of functioning)-operationalized as sense of coherence, posttraumatic growth, and perceived well-being-psychological distress, and trauma symptoms in a specific population of health workers exposed to war and violence. Palestinian health professionals (N = 181) completed quantitative measures of well-being, posttraumatic growth, sense of coherence, psychological distress, and traumatic response. The data were analyzed using structural equation modeling (SEM). The outcomes suggest that sources of psychological functioning consistently play a role in the mental health of different types of health professionals. Health-care workers in an environment characterized by instability and ongoing risk need to protect their own mental health by mobilizing sources of resistance and resilience, such as a sense of coherence, subjective well-being, and growth. We discuss the clinical implications of these findings and offer recommendations for training and supervision. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Immigration is at the forefront of national, state, and local policy struggles in the United States, and Latinx/@ immigrants have experienced increased deportations, detention, and individual threats. A mobilities perspective allows analysis to extend our view of migration beyond frameworks confined to pre- and postmigration, examining trajectories of social inclusion and exclusion that are influenced by multiple factors in the receiving country. The Immigrant Well-being Project, a community-based participatory research project involving university faculty, students, staff, and representatives from 4 community-based organizations (CBOs), was initiated in New Mexico in 2017 to better understand and promote Latinx/@ immigrant mental health and integration by creating change at multiple levels. We began these efforts by conducting an in-depth study of the mental health needs, stressors, current socioeconomic, legal, and political context, and local solutions as experienced by 24 Latinx/@ immigrants and their mixed status families. Five trajectories of immigrant integration emerged: continuous exclusion, simultaneous exclusion and inclusion, continuous inclusion, movement from exclusion to inclusion, and movement from inclusion to exclusion. These diverse mobilities were shaped by participants' social locations, agency, and experiences with CBOs, which played critical roles in creating, maintaining, and/or transforming immigrants' trajectories. However, CBOs could not completely buffer immigrants from the current hostile climate and related stressors that resulted in experiences of exclusion or movement from inclusion to exclusion. These findings add to understandings of immigrant mental health, complex ongoing mobility, and mechanisms of resilience and resistance within the United States and have important implications for policy and practice. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Individuals who survive natural hazards often develop posttraumatic stress symptoms or other forms of psychological distress. However, some experience psychological growth. Given that natural hazards will increase in the near future due to global warming, it would be helpful to examine predictors of growth across different kinds of natural hazards. The present study examined positive psychological factors that may serve as buffers against the negative effects of exposure to a natural hazard, specifically following the Louisiana flooding of August 2016. Volunteer participants (N = 120) self-reported perceived presence and search for meaning in life, social support, resilience, and posttraumatic growth (PTG). After controlling for amount of property damaged, posttraumatic stress symptoms, gender, religion, and ethnicity or race, presence and search for meaning, social support, and resilience explained significant additional variance in PTG scores. This research adds to the growing understanding of how individuals respond to natural hazards. (PsycInfo Database Record (c) 2020 APA, all rights reserved).