American Journal of Orthopsychiatry最新文献

Poor psychological health has been consistently documented for sexually minoritized women. However, little is known about the association between poor psychological health and physical health. This study examined associations between psychological distress and cardiometabolic health, including cardiovascular disease risk conditions (hypertension, high cholesterol, and diabetes) and diagnoses (stroke, coronary heart disease, myocardial infarction, and angina), by sexual identity among women. Data are from the 2013-2018 National Health Interview Survey and included 102,279 women, who were straight (n = 97,909), lesbian/gay (n = 1,424), bisexual (n = 1,235), something else (n = 360), did not know (n = 712), and refused to disclose (n = 639). Multivariable multinomial logistic regression models were fit to estimate associations between psychological distress (measured with Kessler-6) and cardiometabolic health (self-reported diagnosis) and to examine sexual-identity differences in these associations. Covariates included sociodemographic characteristics. Overall, severe psychological distress was associated with significantly higher odds of having a cardiometabolic health condition (OR = 2.66). These associations generally did not statistically significantly differ based on sexual identity. However, potential substantive differences in the magnitude of the association existed among lesbian/gay (OR = 4.00) compared to straight women (OR = 2.73). Moreover, women who identified as gay/lesbian, bisexual, "something else," or "I don't know" all reported significantly higher prevalence of severe psychological distress than straight women. Given the overall positive association between psychological distress and cardiometabolic health as well as the higher prevalence of severe psychological distress among sexual minority women, more work is needed to longitudinally examine the effects of psychological distress on health among sexually minoritized women. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The COVID-19 pandemic and police brutality, especially the murder of George Floyd, have intensified the focus on racial equity within a diverse array of organizations. While a variety of strategies are employed in the pursuit of racial equity in mental health care, there is a notable gap in recognizing the crucial role of individual staff driving change within organizations. Few studies have examined these individuals and the ways they think about their work and its impact. Here, we examine the ways that state health and mental health authority (SH/MHA) staff understand racial equity in mental health care when faced with unusual support for equity reform following the Summer of 2020. Through in-depth qualitative interviews with 58 individuals working in SH/MHAs of 31 states across the United States, we examine the perspectives and experiences of staff engaging in racial equity work when they sense that sociohistoric events perhaps temporarily lifted constraints. Findings confirm the importance of people in the racial equity work process and show that study participants have the characteristics of champions with (a) a conceptualization of (in)equity that involves White systems, including their own organizations, and the need for persistent, sustainable work, (b) an emotional investment toward racial equity, and (c) autonomous motivations of morality and empathy. This study underscores the profound transformative capacity of champions within organizations. Gaining insight into their perceptions and experiences offers a deep understanding of the qualities of a champion and equips us to bolster their pursuits toward racial equity within mental health systems. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The goal of the present study was to examine the role expectations of mentors for care leavers and the factors associated with these expectations-namely, hope, coping strategies, and anticipated closeness with the mentee. The sample included 133 mentors at the beginning of the mentoring relationship. The findings showed that mentors who exhibited higher levels of hope and utilized problem-focused coping strategies were significantly more likely to have task-oriented role expectations. Additionally, the mediation analysis revealed that problem-focused coping served as a mediator, explaining the link between mentors' levels of hope and their task-oriented role expectations. We address the study's findings as they pertain to Snyder's (2002) hope theory and Lazarus and Folkman's (1984) transactional model of stress and coping. Implications for practice include emphasizing the importance of having mentors discuss their initial expectations of the mentoring relationship. In addition, mentoring programs should foster hope among mentors and assess their coping strategies at the outset of the mentor-mentee relationship in order to identify well-suited pairings of mentors-mentees. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Eliminating mental health disparities requires simultaneously addressing numerous determinants of health, including social inequities. Although emphasis on multilevel change is growing, interventions typically involve separate efforts or people focusing on each level. We propose a trans-level conceptual model for mental health intervention that simultaneously facilitates change across multiple intersecting levels with four guiding principles: (1) emphasis on structural change; (2) involvement of people experiencing health and social inequities in achieving structural change by addressing the necessary preconditions of access to resources for basic needs, community membership and belonging, and knowledge or information to participate in social change efforts; (3) valuing and building on the expertise and strengths of individuals, families, and communities experiencing health inequities; and (4) dismantling unequal power dynamics of helping relationships through a focus on mutual learning and support and cocreation of change. Tracing the trajectory of a 23-year community-based mental health intervention partnership (the Refugee and Immigrant Well-Being Project), we illustrate the trans-level intervention model and describe its impact on individual mental health and sustainable change at multiple levels. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study combined a person-oriented approach with a psychosocial framework of help-seeking to examine factors associated with the intent to disclose dating violence among developing adolescents. Data came from adolescents in middle and high school in a rural area in the southeastern United States, who were surveyed annually for 4 years (N_{wave 1} = 580; M_age = 13 years, SD = 1.48; 52.7% female; 49% Black, 39% White, 11% Hispanic, or other minorities). Results confirm expectations that intraindividual (adolescent views on violence and safety); interindividual (peer and family dynamics); positional (gender, having a supportive adult); and ideological factors are all significant predictors of patterns in help-seeking attitudes. However, predictive relevance of some factors varied across help-seeking groups and data collection periods, supporting the differential effects hypothesis. For example, while greater friend social support increased the odds of belonging to "friend confidants," it simultaneously decreased the odds of being a member of "parent confidants" and "moderate help-seekers" groups. Additionally, the influence of family functioning tended to decrease over time, eventually losing its explanatory value at Wave 4. The article concludes by discussing how integration of a person-centered methodological approach with a robust theoretical foundation advances our understanding of variability in adolescents' responses to dating violence. Consideration of diversity in adolescent intentions to react to interpersonal violence is discussed further in the context of policy and practice to enhance protective options and prevent or minimize harm. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The present study aimed to explore the associations between perceived maternal attachment and self-representations of youth in residential care (RC), considering the potential moderator role of youth's sex and age and the potential concurrent effect of frequency and type of family visits and length of time in RC. To this end, a sample of 659 youth aged 11-18 (M = 15.65, SD = 1.72) from RC settings filled out self-report questionnaires to evaluate their perceptions of maternal attachment and self-representations. Results indicated that lower perceived maternal attachment was associated with higher levels of global negative self-representations. Moreover, compared to young men, young women with lower levels of perceived maternal attachment perceived themselves as having more negative self-representations. No moderating effects of age were found. This study contributes to the literature in the field of RC with evidence regarding the association of perceived maternal attachment with self-representations and the moderating role of youth's sex, which informs the development of interventions with this vulnerable population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Concerns about health workers' burnout and psychological well-being have increased as public health crises spread worldwide. This study aims to examine the burnout and psychological distress levels among health care professionals working in our children's hospital 1 month after the 2023 Kahramanmaraş earthquake. A total of 213 health care workers (180 females, 84.5%, mean age 32.67) were included in the study. This cross-sectional study assessed burnout symptoms, psychological distress, and resilience via the Maslach Burnout Inventory, the Depression and Anxiety Stress Scale-21, and the Brief Resilience Scale, respectively. A substantial number of participants (n = 117, 54.9%) reported high emotional exhaustion; approximately half of those were nurses (n = 56, 47.9%). The nurses had higher emotional exhaustion, depression, and stress scores as well as lower self-reported resilience scores than other health care assistants. Higher stress scores were associated with an increased likelihood of high emotional exhaustion, while having more work experience was a protective factor regarding the high emotional exhaustion of nurses. Our results showed that a significant proportion of health care workers had a high level of burnout. Frontline nurses as a group were at heightened risk for psychological distress and emotional exhaustion in the early stages of the disaster. Screening burnout and psychological distress in health care professionals is important for preventive strategies after the disaster. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Although political conservatism has been associated with xenophobia, the processes that may explain this link during the COVID-19 pandemic are unclear. Xenophobia does increase during infectious disease outbreaks, suggesting an adaptation for those concerned about disease threats. Given that disgust facilitates disease avoidance, the present study examined the extent to which disgust proneness (DP) moderated the association between political conservatism and xenophobia during the pandemic. Community participants (n = 277) reporting their political orientation and levels of DP on May 27, 2020 completed measures of COVID-19 xenophobia and COVID-19 anxiety every 2 weeks for a total of 15 timepoints over 30 weeks. Multilevel models revealed that xenophobia was elevated among those high in DP but decreased throughout the pandemic. Xenophobia was also elevated among conservatives but also decreased during the pandemic. Consistent with predictions, DP moderated the effect of political orientation on xenophobia such that at high (but not low) levels of DP, the link between political orientation and xenophobia was significant, with higher levels of conservativism predicting higher xenophobia even when controlling for COVID-19 anxiety. The implications of the present findings for conceptualizing the various processes that explain how political attitudes may fuel xenophobia during future pandemics are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This work expands the theoretical model on the pursuit of happiness in a hostile world, which concerns individuals' coping processes in the face of life adversity while focusing on psychological flexibility, regarded as an adaptive strategy presenting co-occurrence of converse experiences. Psychological flexibility was operationalized by concurrent, positive, and negative affect as well as by differing modes of coping (negative and positive engagement) related to the concept of a hostile-world scenario. The adaptive role of psychological flexibility was examined among Israeli gay men, a sexual minority that deals with unique hardships. Gay men (N = 474, aged 18-84) were pair-matched with equivalent 474 presumably heterosexual men on core sociodemographic variables. Questionnaires assessed the participants' psychological flexibility and psychological wellness as indicated by self-rated health, life satisfaction, depressive symptoms, and neuroticism. The results showed a positive association between psychological flexibility and psychological wellness. Moreover, this association was stronger among gay compared to heterosexual men. In conclusion, the endurance of contradictory experiences may facilitate the adjustment to complex life challenges of sexual minorities. Therefore, researchers and clinicians working with sexual minorities are encouraged to examine coping strategies that enhance psychological flexibility by addressing the adaptational benefits embedded in the coactivation of positive and negative experiences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Transgender people experience an excess burden of child sexual abuse (CSA), mental health concerns, and substance use compared to cisgender populations. Posttraumatic stress disorder (PTSD) has been found to mediate the association between CSA and substance use behaviors in cisgender populations, but this dynamic has not been previously examined among transgender adults. The aim of this study is to test if PTSD may mediate a relationship between CSA and substance use among transgender adults. Data were analyzed from the U.S. Transgender Population Health Survey (2016-2018), a national probability sample of transgender adults (N = 274). CSA was measured using the Adverse Childhood Experiences subsection for sexual abuse. Past-month PTSD was measured using the Primary Care-PTSD Diagnostic and Statistical Manual of Mental Disorders, fourth edition screening tool. Substance use was determined by lifetime binge drinking, polydrug use, and the Drug Use Disorders Identification Test. Baron and Kenny's approach was used to assess PTSD as a mediator between CSA and substance use. Within our sample, nearly half (45%) of the transgender adults experienced CSA. Lifetime binge drinking (40%), polydrug use (20%), and indications of drug-use-related problems (Drug Use Disorders Identification Test x¯ = 4.52) were frequently reported. Transgender adults who have experienced CSA had increased risk of PTSD and substance use, and PTSD was a mediator in all models. Results suggest that adult transgender CSA survivors are at increased risk of drug and alcohol use, and that PTSD may be an important contextual factor for substance use. (PsycInfo Database Record (c) 2025 APA, all rights reserved).