American Journal of Orthopsychiatry最新文献

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) 2024 APA, all rights reserved).

The study assessed stressors and the immediate mental health status of the Ukrainian refugees during the ongoing Ukrainian armed conflict of 2022 and analyzed strategies for reducing anxiety levels. The questionnaire-based prospective study was undertaken in Lviv, Ukraine (five study groups) and Israel (two groups) among 27,901 refugees and 1,259 controls. We assessed the levels of anxiety with General Anxiety Disorder-7 (GAD-7; score range = 0-21, mild to severe) and Refugees' Anxiety Reasons-6 (RAR-6) with a score ranging from 30 (no anxiety) to 6 (extreme anxiety) questionnaires. RAR-6 assessed worries about personal safety, money matters, relatives under fire, the future of the country, limited medications, and general mental fatigue. The study involved refugees in the migration phase and internally displaced persons. The GAD-7 score of 16.1 ± 2.6 (severe anxiety) showed that all participants experienced anxiety during current hostilities. The RAR-6 score of 21.8 ± 1.7 demonstrated that participants worried about numerous acute problems, but the results varied from group to group. The refugees who moved abroad independently and without a clear goal had the worst GAD-7 score of 19.4 ± 1.7. The refugees who traveled abroad in a group-organized manner had the best RAR-6 score of 24.8 ± 1.5, while passing through Lviv refugees had the worst RAR-6 score of 19.0 ± 1.6 (p = .03). During hostilities, refugees, internally displaced persons, and regular inhabitants are mentally affected to varying degrees. For refugees, group-organized travel abroad is the best option to maintain adequate mental health, followed by an internal refugee status and traveling abroad independently (the worst strategy). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Help-seeking attitudes among Arab/Middle Eastern North African (MENA) Americans remain an understudied outcome, despite significant levels of reported mental health concerns. Hierarchical linear regression was used to examine whether Arab/MENA Christians and Muslims' help-seeking attitudes were significantly associated with acculturation, enculturation, and religious orientation. Results indicated that acculturation levels were positively associated with help-seeking attitudes, wherein individuals with higher levels of dominant society immersion were more likely to report more positive attitudes toward help seeking. Extrinsic social religious orientation (ESRO) interacted with religious affiliation (i.e., Christian or Muslim) wherein higher levels of ESRO were associated with lower help-seeking attitudes for Muslims but not Christians. Moreover, enculturation and religious affiliation interacted so that higher levels of enculturation were associated with less positive help-seeking attitudes for Christians and more positive help-seeking attitudes for Muslims. Finally, intrinsic religious orientation interacted with religious affiliation so that increasing levels of intrinsic religious orientation predicted lower levels of help-seeking attitudes for Muslims and higher levels for Christians. These findings have implications for working with Arab/MENA groups and implementing interventions to improve access and attitudes toward mental health services, which are often stigmatized (i.e., socially devalued) in this population. (PsycInfo Database Record (c) 2024 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) 2024 APA, all rights reserved).

Reports an error in "Alone in the shadow of terror: Coping strategies and internal resources of older adults living alone in a continuous traumatic situation" by Shirly Hadida-Naus, Gabriela Spector-Mersel and Sharon Shiovitz-Ezra (American Journal of Orthopsychiatry, 2023, Vol 93[3], 188-197). In the article (https://doi.org/10.1037/ort0000667), the title was corrected to "Alone in the Shadow of Terror: Coping Strategies and Internal Resources of Older Adults Living Alone in a Continuous Traumatic Situation" because the word "coping" was omitted during the composition of the article. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2023-61652-001.) Continuous traumatic situations (CTS) caused by prolonged exposure to terrorist threat can harm individuals' mental and physical health. For older adults living alone in CTS, this risk joins the challenges of aging and loneliness, creating a triple vulnerability. No previous research has explored this particular vulnerability and specifically addressed the coping strategies and internal resources used by older adults to manage these stressful circumstances. The present study aimed to fill this lacuna, by exploring how older adults living alone in CTS cope with these challenges and the internal resources that help them do so. In-depth interviews with 15 persons aged 65 + years living alone in Sderot, an Israeli city exposed to a continuous terror threat, were conducted and analyzed thematically. Participants described various coping strategies. Some are deployed at the psychological level: positive thinking, deliberate disengagement, perception of being alone as an advantage, and social comparison; others have behavioral implications: acknowledging reality and dealing with it and "turning it into an engine." Participants also identified four internal resources that helped them cope: functional independence, faith, character traits, and previous experience with stressful life events. Participants coped with the difficulties of living alone in CTS actively and creatively, relying on various psychological and functional resources. The findings support theories that emphasize older adults' resilience and ability to cope with stress and trauma, suggesting ways to strengthen the resilience of older adults facing CTS, particularly those living alone. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Language barriers are among the most critical factors in health care disparities. Low language proficiency is consistently associated with a high prevalence and severity of mental health disorder symptoms. Despite the advantages of working with an interpreter, most practitioners report difficulties, especially with trust and the feeling of control. The main objective of this exploratory qualitative intervention research is to examine the impact of training when working with interpreters and their inclusion in follow-ups. This impact is evaluated in the changes in feelings of control and trust for the practitioners who received the training, for the trained interpreters included in follow-ups and for the patients of these follow-ups. Semistructured interviews were conducted with individuals involved in five follow-ups at four public mental health clinics in Paris, France. The project had two phases: before (N = 18) and a few months after (N = 12) the training. Interviews were transcribed and thematically analyzed. Before the training, practitioners perceived the potential for collaboration with interpreters and the complexity of triadic consultations. Interpreters expressed irritation and disappointment at the lack of recognition, and patients seemed confident because they had already built a relationship with practitioners. After the training and inclusion of interpreters, trust is better established between interpreters and practitioners, which has substantial effects. All the protagonists state that trust positively impacts the relationship with patients and the therapeutic process. Although some practitioners still doubt the sessions' control, the intervention helps them to gain knowledge and critically examines their clinical modus operandi. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

When undocumented immigrant parents are deported from the United States, they must decide whether or not to take their U.S.-born and undocumented immigrant children with them, often to countries the children have never visited or know little about. Other parents do not wait to be deported by the government and decide to relocate to their home countries with or without their children. Both sets of families experience relocation but under different circumstances. These differences deserve exploration to understand the psychological and emotional effects on children's well-being. In this cross-sectional study, we explored differences in self-concept, internalizing and externalizing behaviors, as well as the perception of the home, school, and neighborhood contexts of 178 U.S. citizen children (USCC) whose parents returned to Mexico forcibly and voluntarily. Through snowball sampling, we recruited the sample from two bordering Mexican states, Michoacán and the State of Mexico. Significant estimated marginal mean differences in internalizing and externalizing behavior problems, unhappiness, as well as parent-child conflict and support were found between USCC who relocated due to a parental deportation and those USCC whose parents relocated to Mexico voluntarily. Implications for clinicians in Mexico and the United States include recognizing the reasons, timing, decisions, events, and contexts of relocation. Findings can help inform immigration policies, practices, and future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Decision making is the basis for individual autonomy and societal participation. To support persons' human right to make life decisions, the model of supported decision making (SDM) has evolved and complies with Article 12 of the United Nations Convention on the Human Rights of Persons with Disabilities. Models for implementing SDM and outcomes achieved by applying SDM in community settings remain insufficiently explored. This study used a human rights perspective with participatory, qualitative research methods to investigate environmental conditions and social support measures that enabled persons with intellectual disabilities (ID) to make and implement their own decisions. Data gathered were 6 months of field notes about implementing SDM in a L'Arche day activity program with 26 adults with ID, with opinions and drawings illustrating persons' decision making. All data were analyzed thematically. As a result of using the SDM intervention, persons with ID became more expressive, able to discuss and debate options, participated in organizational and municipal decision making, and expressed "joy" and feeling "more like a human." Staff supporters found SDM fulfilling and noticed it increased the sense of ownership persons with ID experienced in individual and group meetings. An organizational environment that respects human dignity, supports sustained relationships between persons with ID and decision supporters, individualizes SDM depending on how persons can communicate, and encourages staff self-reflection about prejudices and positionality is essential for implementing SDM with persons with ID. SDM processes shift oppressive social narratives and policies in the direction of a social, relational model of the decision-making capacities and competencies of persons with ID. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Gun violence is a serious public health problem that places surviving victims at increased risk for a variety of mental health problems, including posttraumatic stress disorder (PTSD) and depression. Recognizing that many gunshot injury survivors lack access to mental health care in the early aftermath of a shooting, there has been growing interest in the use of early, preventive mental health interventions to help prevent long-term mental health complications like PTSD as part of routine care for survivors in acute medical settings, where initial outreach to survivors may be more successful. This study evaluates clinical outcomes associated with one such early intervention-Skills for Psychological Recovery (SPR)-provided to gunshot injury survivors as part of a hospital-based early intervention program embedded in a Level 1 trauma center in the Midwestern United States. Clinic data from 100 survivors (74.0% male, 78.0% Black/African American) who received SPR were included in the present study. Results suggest that receiving SPR in the early aftermath of a shooting is associated with statistically significant reductions in both PTSD, F(1, 26.77) = 22.49, p < .001, and depression, F(1, 29.99) = 6.49, p = .016, symptoms. Outcomes did not vary as a function of either PTSD risk status or intervention delivery method (i.e., in-person, telehealth). These findings support the effectiveness and acceptability of SPR as an early intervention for gunshot injury survivors when delivered as part of a hospital-based early intervention program. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This exploratory study examined hope among at-risk young adults and the factors associated with hope including income, housing, self-rated health, and education. The study, conducted among Israeli at-risk young adults, included 589 participants, ages 18-25 who received some form of treatment at one of Israel's social welfare service agencies. Findings indicated that young adults who had experienced housing instability/insecurity during the past year had lower levels of hope compared to participants who had not experienced housing instability/insecurity. Structural equation modeling revealed housing security, higher income sufficiency, and higher education were associated with higher levels of hope. The discussion addresses the importance of recognizing both protective and risk factors for positive adjustment among at-risk young adults. Implications for practice emphasize the importance of considering instrumental, as well as psychological and motivational, aspects in intervention programs that support at-risk young adults during the transition to adulthood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).