Psychology Health & Medicine最新文献

An increasing number of women are conceiving through assisted reproductive technology; however, few studies have investigated their mental health after successful conception. This study investigated the changes in depressive symptoms in women using assisted reproductive technology and the association between the mode of conception and perinatal depressive symptoms. A longitudinal observational study was conducted from 2015 to 2019, 542 pregnant women completed questionnaires on depressive symptoms at eight timepoints during the prepregnancy, pregnancy and first-year postpartum periods. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. A generalized estimating equation regression model was employed for repeated measures. In the assisted reproductive technology group, depressive symptoms were more prevalent during early pregnancy and at 1 month postpartum than before pregnancy, and more prevalent before pregnancy and at 1 month after childbirth than in the spontaneous conception group. No significant association was identified between the mode of conception and depressive symptoms during the antenatal or postnatal period. The lack of full-time employment and prepregnancy depressive symptoms were associated with antenatal depressive symptoms. Primipara status and depressive symptoms during prepregnancy and pregnancy were associated with depressive symptoms during the first-year postpartum. Assisted reproductive technology was not a risk factor for depressive symptoms during the pregnancy and postpartum periods, whereas primipara status, lack of full-time employment and prepregnancy depressive symptoms were negative predictors. Therefore, targeted mental health interventions should address these specific factors to effectively support maternal mental health.

Several studies have shown high rates of mental health problems amongst doctors in training worldwide. Self-care has been shown to be protective against burnout and increases subjective wellbeing. This study aims to investigate the self-care practices of foundation year doctors (FYs) in Malta. All doctors enrolled in Foundation Programme Malta in 2022 were invited to participate in an online questionnaire containing the Mindful Self-Care Scale (MSCS). Confirmatory factor analysis confirmed the 6-factor model described in literature. The independent sample t-test and Mann-Whitney U-test were used to check for relationships between total scores and variables of interest and means and medians for each group were compared. A total of 122 doctors answered the questionnaire out of 264 (46%). The median score for our FY cohort was 68, indicating moderate levels of self-care. Almost 40% of participants rarely or never experienced a sense of meaning at work. Working for long hours under stressful conditions means that self-care must be one of the top priorities for new doctors. However, very few FYs working in Malta regularly care for their physical and mental health. Strategies to improve trainee wellbeing must first focus on systemic factors to allow the individual factors to be addressed.

The study aimed to evaluate whether a 12-week physical exercise intervention would improve psychological resilience and mental ill-being (e.g. internalising and externalising symptoms) in medical-naïve children with Attention-Deficit/Hyperactivity Disorder (ADHD). In a parallel two-group randomised controlled trial (RCT) design, 30 children between 8-12 years (M_age = 8.62 ± 1.37) formally diagnosed with ADHD were assigned to a 12-week physical exercise intervention group (three sessions per week for 60 mins, moderate-to-vigorous physical activity [MVPA] intensity) or a control group (treatment as usual). Psychological resilience was measured by a self-reported Chinese version of the 25-item Connor-Davidson Resilience Scale, and mental ill-being was assessed by a parent-reported Chinese version of the 113-item Achenbach's Child Behavior Checklist. The 12-week physical exercise intervention with MVPA level revealed a significant improvement in psychological resilience (F = 4.82, p = .038) and a significant reduction in internalising symptoms (e.g. anxiety/depressed, withdrawn/depressed, and somatic complaints) (F = 7.11, p = .013) and externalising symptoms (e.g. rule-breaking behaviour and aggressive behaviour) (F = 21.09, p < .001) in the intervention group but not in the control group. Moderate correlations were revealed between the changes in psychological resilience and the changes in internalizing (r = -.557, p = .031) and externalising symptoms (r = -.647, p = .009) in the intervention groups (n = 15). The findings of this study provide initial support for the efficacy of physical exercise intervention on psychological resilience and mental ill-being and for the potential mechanisms of psychological resilience under the effects of exercise-induced mental ill-being improvements in children with ADHD.

To examine the association between clinical personnel's general attitudes towards new interventions and implementation outcomes related to an evidence-based individualized, culturally tailored, computerized decision aid (DA) for the management of lupus. To assess attitudes, the validated Evidence-Based Practice Attitudes Scale (EBPAS) survey was emailed to personnel in 15 rheumatology clinics across the U.S. The survey also included questions related to three validated implementation outcomes: lupus DA acceptability, appropriateness and feasibility. The baseline round of the survey was fielded from August 2019 to January 2020 and yielded a 56.8% response rate (n = 76 respondents). We also collected organizational characteristics from each clinic and personnel-level control variables. Overall, respondents reported modest levels of lupus DA acceptability, appropriateness and feasibility (3.54, 3.45 and 3.40, respectively, on a scale of 1-5). Multilevel regression analyses demonstrated statistically significant positive relationships between a respondent's openness to new practices/interventions and perceived lupus DA acceptability (β = 0.31, p < .01) and feasibility (β = 0.28, p < .05). Divergence (a respondent's perceived difference between current and new practices) was not associated with clinic personnel perceptions of the DA. These findings suggest that understanding clinic personnel general attitudes toward new interventions is an important precursor to implementing evidence-based practices and may provide important diagnostic information about places to intervene in preparation for implementation and improving shared decision-making with patients.

The main aim of the present study was to evaluate the relationship between Posttraumatic Stress Symptoms (PTSS) and rumination (intrusive and deliberate) in individuals who experienced a traumatic event at different times. In particular, to better understand the possible mechanisms underlying the association between PTSS and rumination, the study aimed to explore whether the time since the traumatic event could serve as a moderator of the relationship between PTSS and rumination. To achieve this objective, 601 participants were recruited using a snowballing strategy and were asked to complete the PTSD Checklist for the DSM-5 and the Event-Related Rumination Inventory. Results of regression analyses showed that intrusive rumination was associated with the presence of PTSS regardless of the time since the event. Conversely, deliberate rumination was found to be significantly related to the presence of PTSS, but this association was moderated by time. From a clinical point of view, it appears particularly useful, when treating an individual with PTSS, to consider not only the type of trauma and the time elapsed since the event but also the type of cognitive re-elaboration that the individual enacts.

Postpartum Depression (PPD) is a major health challenge with potentially devastating maternal and physical health outcomes. Development of diabetes mellitus has been hypothesized as one of the potential adverse effects of PPD among mothers in the postpartum period, but this association has not been adequately studied especially in low resource settings. This study aimed at determining prevalence of postpartum depression and its association with diabetes mellitus among mothers in Mbarara District, southwestern Uganda. We conducted a facility based cross-sectional study of 309 mothers between 6th week to 6th month after childbirth. Using proportionate stratified consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health center IV. PPD was diagnosed using the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diabetes mellitus was diagnosed by measuring Hemoglobin A1c (HbA1c). Logistic regression was used to determine the association of PPD and diabetes mellitus among mothers. The study established that PPD prevalence of PPD among mothers of 6th weeks to 6th months postpartum period in Mbarara was 40.5% (95% CI: 35.1-45.1%) and it was statistically significantly associated with diabetes mellitus in mothers between 6 weeks and 6 months postpartum. The prevalence of diabetes mellitus among mothers with PPD was 28% compared to 13.6% among mothers without PPD. Mothers with PPD had 3 times higher odds of being newly diagnosed with diabetes as compared to those without PPD (aOR = 3.0, 95% CI: 1.62-5.74, p = 0.001). Mothers with PPD between 6 weeks and 6 months postpartum are more likely to have diabetes mellitus as compared to those without PPD. Well-designed prospective analytical studies are needed to conclude on the risk of diabetes mellitus in relation to PPD. Early screening of PPD may be considered in postpartum mothers.

Although medical mistrust is associated with lower cancer screening uptake among racial minorities, such as African Americans, potential impacts on cancer screening among White Americans are generally understudied. In this study, we examined links from medical mistrust to lung cancer screening among African American (N = 203) and White American (N = 201) smokers. Participants completed the Group-Based Medical Mistrust Scale and viewed a brief online educational module about lung cancer risks, etiology, and screening. Thereafter, participants reported their receptivity to lung cancer screening using a Theory of Planned Behavior (TPB) measurement framework (attitudes, normative beliefs, perceived control, and intentions). Medical mistrust predicted lower screening receptivity across all TPB measures for both racial groups. Although medical mistrust was higher among African Americans, there were no race differences in screening receptivity. However, there was some evidence that race moderates the relationship between medical mistrust and screening attitudes. While greater mistrust predicted more negative attitudes among both races, this effect was stronger among White Americans than African Americans. Findings suggest that group-based medical mistrust is a barrier to lung cancer screening for both African Americans and White Americans and illustrates the need to address medical mistrust as a barrier to screening for both racial minority and nonminority populations.

To date, previous research has elucidated the impact of adult attachment type on marital relationships. However, the mechanisms underpinning the relationship between attachment type and marital adjustment in breast cancer patients remain unclear. In this study, a cohort of 272 breast cancer patients was surveyed using several instruments: the General Information Questionnaire, Revised Marital Adjustment Scale (RDAS), Adult Attachment Scale (AAS), Interpersonal Reactivity Indicator Scale (IRI), and Regulated Emotional Self-Efficacy Scale (RESS). We conducted moderated mediation analyses using the SPSS macro program PROCESS plug-in. Empathy was found to mediate the association between attachment type (attachment anxiety/attachment avoidance) and marital adjustment, with indirect effects of -0.141 (95% CI [-0.260, -0.063]) and 0.157 (95% CI [0.073,0.289]), respectively. Additionally, affect regulation self-efficacy was found to mediate the subsequent impact of attachment type (attachment anxiety/attachment avoidance) on marital adjustment via empathy, with moderated effects of 0.380 (95% CI [0.236, 0.525]) and 0.374 (95% CI [0.240, 0.509]), respectively. Consequently, the presence of insecure attachment in breast cancer patients appears to influence their empathy levels, thereby negatively impacting marital adjustment. Encouragingly, enhancing emotional regulation self-efficacy in patients holds the potential to mitigate these adverse effects. These findings contribute not only to a deeper theoretical understanding but also lay a solid foundation for practical interventions aimed at enhancing marital relationships among breast cancer patients.

Loneliness and depression are the most prevalent mental health issues among older adults, and their relationship has been documented in studies using reflective psychopathological models based on the total scores. However, mental health problems should be investigated at the level of individual symptoms in order to develop intervention strategies aimed at mitigating the adverse impact of both variables. The goal was to examine the extent to which symptoms of loneliness relate to symptoms of depression in elderly Peruvians using the network method in 328 Peruvian adults with an average age of 68.44 years (SD = 7.64). The participants were selected through non-probability convenience sampling, which may limit the generalizability of the results. The Patient Health Questionnaire-2 (PHQ-2) and three-item UCLA Loneliness Scale were used in this study. Network analysis was used to identify central and bridging symptoms within the network of loneliness and depressive symptoms. Furthermore, the invariance in symptom networks between men and women was estimated. The results indicated that 'feeling excluded' was the most central symptom. Furthermore, the symptoms 'feeling excluded' and 'anhedonia' have the strongest relationship and can be considered as bridge symptoms between loneliness and depressive disorders. Symptom networks were invariant between men and women (M = .26; p = .42; S = .09; p = .38). In conclusion, the network structure provides valuable insights into the relationship between the symptoms of loneliness and depression in older Peruvian adults. The results suggest that the symptoms 'feeling excluded' and 'anhedonia' could serve as potential targets for psychological interventions aimed at efficiently reducing loneliness and depression.

Integrative models of mental illness and health in psycho-oncology are aimed at all types of cancer, although the patients' experiences and issues may vary. This review summarizes the different theories and models of mental illness and health pertaining to the breast cancer experience and proposes an integrative phasic model applicable to the breast cancer trajectory. Five databases were searched for studies related to breast cancer mental health and illness theories and models. The PRISMA checklist form was used to extract the essential information from the included studies. Eleven theories and models on the experience of breast cancer were found. The integrative model based on these theories and models illustrates that the breast cancer experience is conceptualized as a trajectory with seven landmark 'events', each associated with a pathogenic 'challenge' leading to six possible 'symptoms', 1) psychological distress with anxious features, 2) psychological distress with depressive features, 3) non-specific distress 4) psychological distress with trauma-related features 5) low health-related quality of life, and 6) fear of recurrence. The Breast Cancer Psychological Integrative Phasic Model is supported by a simple clinical tool (BreastCancerPsych - Integrative Clinical Tool) that serves as a valuable resource throughout the care trajectory. These integrative phasic model and clinical tool are designed to help mental health clinicians formulate treatments that are tailored to the needs of their patients, especially for trajectories that are not marked by resilience.