American Journal of Orthopsychiatry最新文献

A number of studies now confirm that the COVID-19 pandemic has increased and exacerbated mental health problems in the general population. Previous quantitative studies have found similar effects on mental health symptoms among adults with histories of childhood adversity; however, qualitative research is needed to provide a more in-depth understanding of pandemic-related experiences among this vulnerable population. Using semistructured qualitative interviews, we explored perceptions of adults with histories of child maltreatment and neglect to better understand the overall impact of the pandemic on their mental health, reported changes in stress and alcohol use, and reported coping strategies during the first year of the pandemic (N = 40). Approximately half of participants reported that the pandemic had greatly (negatively) impacted their life, relationships, and well-being. Contributing stressors included being fearful of getting sick, navigating work changes, and experiencing economic and housing hardships, grief and loss, and social isolation. Fewer than half of the sample reported more stress (46%), whereas a third (33%) indicated no changes to stress, and 10% had reduced stress. The majority (80%) indicated no changes in their alcohol use. Most participants reported they used positive coping strategies during the pandemic. Three primary themes emerged related to participants' perceptions of getting through difficult times: seeking outside support, engaging in positive reframing, and drawing on internal strength and resources. Findings can guide prevention strategies that strengthen social support and foster resilience among vulnerable populations of adults with histories of childhood maltreatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexual and gender minority (SGM) individuals endure a number of health disparities, such as higher rates of violence, mental health conditions, and medical concerns. These disparities are exacerbated by the fact that SGM individuals face stigmatizing health care provider and system-related experiences. The primary purpose of this study was to quantify health service providers' SGM health competency by developing a measure, namely the Health Care Competency Assessment Form-Sexual and Gender Minority Patients (HCAF-SGM). Further, we examined correlates of SGM health competency based on leading theories of prejudice, primarily the dual process model of prejudice and social identity theory. The study comprised two phases: item development and pilot testing, followed by a primary online survey administration with several health care professionals and training organizations (N = 155). Study findings supported a one-factor HCAF-SGM score, suggesting that health care providers view their competency regarding SGM individuals in a holistic manner, without differentiating between knowledge, attitude, and skill. The measure was found to be negatively associated with right-wing authoritarianism and positively correlated with specific social identities most salient to the topic of SGM health (i.e., health care professional and SGM). The HCAF-SGM shows promise as a reliable and valid assessment of perceived provider health care competency. Implications for SGM health-related measurement, clinical supervision, and training are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An online sample of 528 people was asked to respond to a hypothetical scenario: If a police car came up right behind you with its lights flashing, how much would you worry that you would be killed? Participants also reported on whether they experienced aggressive behavior by police in the past (provoked or otherwise) and, if so, completed a measure of associated posttraumatic stress. At least some fear of being killed by police (FKP) in the rearview mirror scenario was reported by the majority (56%) of Black participants, 39% of those self-describing as "other or mixed" race, and 31% of Hispanic participants, as compared to 26% of those of Asian descent and 19% of those identifying as White. When the highest level of FKP was considered, Black participants were 12 times more likely than White participants to report "extreme" fear of death at the hands of police. Lesbian, gay, bisexual, transgender, queer, and more participants were also more likely than cisgender/heterosexual respondents to report both FKP (35% vs. 20%) and "extreme" FKP (8% vs. 3%). FKP was also more prevalent among those self-reporting unprovoked police aggression in the past and those for whom police aggression had led to posttraumatic stress disorder. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Marion Kenworthy (1891-1980) was a pioneering child psychiatrist, mental hygiene and child guidance leader, and early member of the American Orthopsychiatric Association (now the Global Alliance for Behavioral Health and Social Justice). Throughout her illustrious career, Kenworthy advocated for values in the emerging field of child psychiatry, especially around prevention of mental illness, interdisciplinary collaboration, and social justice. Kenworthy's history provides not only an illustration of the importance of values in the work related to children but also a reminder of perspectives that can get lost in the contemporary focus on individual diagnoses and treatments (especially with pharmaceuticals). The social, cultural, and economic problems encountered by Kenworthy and her contemporaries remain as challenges in the present and the future, ones that require ongoing interdisciplinary collaboration and advocacy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

On the 100th birthday of the Global Alliance for Behavioral Health and Social Justice, it is appropriate to reflect on the evolution of thought on depression prevention research, as seen through a historical perspective, to note how the field has grown and how it can address the issues of today. This article is a personal reflection on one practitioner's evolution of thought on resilience and preventive intervention, starting with interviewing civil rights workers, to conceptualizing self-understanding as an essential component of resilience, to the development of a family-based preventive intervention for parental depression, which was disseminated, adapted, and incorporated into a growing body of prevention research. Consensus statements on mental health prevention from the National Academies are reviewed, and the importance of a social justice perspective is highlighted throughout. The article concludes with principles for developing effective preventive interventions to promote mental health today, and in the future. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This commentary examines key mental health policies across four transformative historical periods in America: the aftermath of World War II (1939-1946), the Civil Rights Movement (1954-1968), the Great Recession (2007-2009), and the COVID-19 pandemic (2020-2023). The post-WWII era established today's foundational mental health system, emphasizing military personnel, as reflected in the National Mental Health Act of 1946. During the Civil Rights Movement, the focus shifted toward community equality, leading to the Community Mental Health Act of 1963. The economic challenges of the Great Recession, especially affecting young adults, prompted a deep dive into the Affordable Care Act. The social isolation and economic suffering from the COVID-19 pandemic led to the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The article highlights the need for a more inclusive policy development approach, one that recognizes and integrates the unique perspectives of young adults in shaping mental health policies and discourse. It concludes with recommendations to guide future policy evolution for enhanced mental health and societal well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Group-based parent training (PT) is an evidence-based approach for strengthening parenting skills and reducing child behavior problems. However, there has been little research on the social connectedness (SC) formed among PT participants, particularly in low-income communities where parents may be more socially isolated. This study describes SC formed among parents in a group-based PT program implemented in their children's school and its association with changes in child behavior. Using a convergent mixed-methods design, data collection occurred between 2020 and 2022. Parents (n = 97) completed measures of their SC to other parents in their PT group and their child's behavior. Qualitative interviews with a representative subsample of parents (n = 17) were also conducted to understand parents' perceptions and experiences of SC within their PT group. Parents reported high levels of SC (M = 4.45 [range = 3.04-5 on scale of 1-5]; SD = 0.4). From baseline to postintervention, the number of children with child behavior problems significantly decreased (32.12%, 37.5% behavior intensity and problems, respectively). The magnitude of decline in child behavior problems was significantly related to parents' SC (b = -11.52, p = .02, SE = 4.99). Qualitative data confirmed high levels of SC, which parents linked to improvements in their parenting and children's behavior. Themes focused on the building of connections, committing to a safe space with parents who share similar goals, supporting one another, and gaining connections within the school environment and during the COVID-19 pandemic. Results highlight the potential synergistic effects of SC formed in the context of group-based PT with implications for strengthening parenting skills and children's well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Many White parents engage in minimal discussion of race and racism with their children, instead engaging in color-evasive practices that communicate that race is unimportant and that White people are racially neutral. Even White parents who express a commitment to anti-racist parenting frequently struggle to act on this commitment and feel underprepared to do so. The current mixed methods pilot study focused on the feasibility, acceptability, and participant experiences of an intervention ("CounterACT") that aimed to address this gap in White U.S.-based parents' skills and knowledge. Participants in the study were 27 White U.S.-based parents of 4- to 6-year-old White children who completed pre- and postintervention surveys as well as postintervention interviews. Findings suggest that the CounterACT model was feasible and acceptable. Parent self-report further suggests that CounterACT had beneficial effects on parenting, parents' beliefs regarding White privilege, and children's critical reflection. Parents reported positive experiences of CounterACT, particularly group components of the intervention. Key elements of participants' experience included learning to understand their own and their children's experience of Whiteness; learning to better tolerate and regulate emotional discomfort; connecting with others for motivation, accountability, and learning; and approaching racial socialization with greater intentionality. However, parents also experienced limits in their progress toward anti-racist parenting. Many indicated a desire for more concrete guidance and greater support enacting what they were learning in their own parenting. A particular concern was how to discuss White racial identities effectively. Our discussion highlights the implications of these findings for future work in this area. (PsycInfo Database Record (c) 2024 APA, all rights reserved).