Mental Health and Prevention最新文献

Background

Suicide is a serious public health problem. All 194 member states of the World Health Organization have signed the Comprehensive Mental Health action plan 2013–2030 which tasks governments with implementing evidence-based interventions in community settings to prevent suicide at all stages of life. This study aims to map the priorities in suicide prevention policy in community-settings in Sweden, one of the World Health Organization's member states.

Method

A document study, using data from suicide prevention policy documents in the 21 counties in Sweden. Data was analyzed using qualitative content analysis.

Results

Suicide prevention interventions at the universal, selective and indicated prevention levels were prioritized. Most of the suicide prevention interventions intended to be implemented at each prevention level was evidence-based. Most of the suicide prevention interventions at all prevention levels did not prioritize any specific age group, however when age groups were targeted there were some emphases on children and adolescents.

Conclusion

There is a need to improve suicide prevention interventions prioritizing age-groups who have high suicide rates. As educational interventions that encourage young people to develop their ability to face life challenges related to adolescence are found to be appropriate suicide prevention interventions, so too could educational interventions aimed at other age-groups be developed, to enable them to develop their ability to face life challenges related to their age.

The goal of the current study was to adopt a novel comprehensive approach to examine the efficacy of the targeted intervention component of a multilevel prevention program. We addressed four fundamental issues with this approach: (1) Distinct subpopulations within the sample; (2) Characteristics of those who chose to complete the intervention and those who did not by profile; (3) Changes in the experimental group by profile; and (4) Changes in the comparison group by profile? Latent Profile Analyses revealed that our initial sample of students identified as at-risk due to current symptoms of distress, clustered into three distinct profiles of risk (High Risk (HR), Average Risk (AR) and Low Risk (LR)). Regarding characteristics related to opting for active participation, we found that the higher the level of initial risk, the more likely students were to opt to participate in the program, and within the AR profile, we found that those participants with lower study skills opted more often for the intervention. Latent Growth Modeling, in the experimental group, showed that the HR profile benefited substantially from participation in the intervention with significant reductions in symptoms and risk factors, as well as significant increases in protective factors. Changes in the AR profile were in the expected direction, but this group remained notably anxious although not depressed anymore. The LR profile showed significant reductions in symptoms following the intervention. In the comparison group, the HR profile improved some, the AR and the LR did not change significantly, except for significant decreases in personal goal and values consolidation in the LR profile. The current study highlights the importance of adopting a more comprehensive evaluation of efficacy and how this must inform selection criteria for future studies.

Parents’ emotion socialization behaviors remain important into adolescence, but less work has measured socialization behaviors relative to self-reports involving adolescents. We considered how mothers’ emotion socialization behaviors—captured during family storytelling—could differ given adolescent age and gender and could be linked with measures of adolescent adjustment. We recruited 45 mothers and adolescents (M age = 13.6 years, SD = 1.4; 51.1% girls) to complete conversations about life events and family stories. Adolescents also provided information on their depressive symptoms and social support from the family. Among adolescents who endorsed more depressive symptoms, mothers’ structural, egocentric, and factual communication behaviors were negatively associated with depressive symptoms and positively associated with family support. This provided support for a compensation hypothesis in socialization toward adolescents. Further, findings challenged views about mothers’ egocentric behaviors toward adolescents. We discuss ways parents’ behaviors using themselves as sources of insight for adolescents could be developmentally appropriate.

Mental illness is prevalent amongst university-aged individuals; however, stigma makes it difficult for these individuals to reach out for support. Arts-based approaches, specifically, digital storytelling interventions, have shown promise in addressing mental health difficulties and stigma. This study involved university students viewing a set of digital storytelling films (the Out of Darkness project – which were originally created for medical residents in psychiatry) and then participating in a focus group discussion to explore students’ experience of watching the films. We transcribed focus group discussions and used thematic analysis to uncover student perspectives of the digital storytelling intervention. The major themes identified include a change in attitude, empathy, and compassion, encouraging conversation, recognizing the importance of support, increased understanding that mental illness is not a choice, and acknowledging the stigma that still exists. The findings of this study suggest that the Out of Darkness digital storytelling intervention has merit beyond the training of medical professionals and can act as a valuable tool for addressing the stigma associated with severe mental illness on university campuses.

Objective

Mental health problems among youth have increased significantly over the past several decades. While there is growing evidence that the gut microbiome may be an important mechanism affecting mental health, results of the limited studies focused on children, adolescents, and young adults have not been synthesized. This scoping review examined existing literature to identify key findings on the associations between the gut microbiome and mental health of youth.

Methods

A literature search using PubMed, PsycINFO, and CINAHL was performed, and bibliographies were manually searched. Eighteen articles met eligibility for the review. Findings from each study were evaluated, focusing on associations of specific mental health problems to bacterial composition and diversity among youth. There were no studies solely on the adolescent age group, so data was synthesized comparing the child/adolescent (2 to <18 years of age) and young adult (18–25 years of age) groups.

Results

Most studies utilized 16S rRNA for gut microbiome analysis, and various mental health conditions were examined. Findings for both age groups were mostly inconsistent. However, bifidobacteria was generally associated with better mental health across age groups. Diversity of microorganisms was decreased for children/adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) and high levels of stress but increased for young adults with ADHD and Major Depressive Disorder.

Conclusion

Future research should replicate studies to clarify findings, examine species-level effects and their functions, consider longitudinal designs to assess directionality of associations, and conduct clinical trials to examine the effects of putative probiotics in the management of psychological symptoms.

Brief, scalable, and transdiagnostic prevention efforts are needed to prevent depression and anxiety among college students. Growth mindset interventions are brief, often web-based interventions to prevent or reduce depression symptom severity that have not yet been evaluated within a college student population. In this study, college students (n = 371) were randomized to either a web-based growth mindset intervention or a psychoeducation control. We examined acceptability and usability ratings as well as the impact of the intervention on new-onset depression and anxiety and symptom trajectories as assessed by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) over a six-month period. Results indicated that participants found the intervention to be acceptable and usable. Assessing the potential of the intervention as a universal prevention approach among participants below clinical cutoffs at baseline (GAD-7 or PHQ-9 <10, N = 239 and N=229, respectively), the intervention was not associated with a reduction in new-onset depression or anxiety, nor a reduction in depression symptom trajectories compared with the control group. Control group participants experienced a greater increase in anxiety symptoms severity than participants receiving the intervention (d = 0.24). Among individuals above clinical cutoffs at baseline (GAD-7 ≥ 10; N=132, or PHQ-9 ≥ 10; N=142), the intervention reduced symptom severity to the extent that it changed beliefs about emotions. While the intervention was acceptable among college students and demonstrated promising effects on anxiety symptom severity and changes in beliefs about emotions, more work is needed to strengthen this approach to prevent new-onset depression and anxiety.

Trial registration: ClinicalTrials.gov Identifier: NCT03707522

Background

Mental health-related podcasts are an increasingly popular medium, however, little is known about the influence of demographic and personal mental health characteristics on listeners’ engagement and experiences. The present research seeks to explore the motivations and experiences of mental health-related podcast listeners.

Method

Data was gathered via an online survey (N = 722) and analysed to examine factors associated with participants’ reasons for, and experiences of listening to mental health-related podcasts.

Findings

Results indicate that mental health-related podcast listeners’ motivations and experiences are centred around developments in mental health literacy. Participants with the lowest levels of education and mental health literacy reported the most significant benefits from listening to mental health-related podcasts.

Conclusion

These findings provide evidence for positive outcomes of listening to mental health-related podcasts. Future research should aim to deepen our understanding of the medium, with emphasis on investigating their potential use as a psychoeducational tool for personal and/or professional development.

Maternal depression is a prevalent psychological concern that affects all racial and ethnic groups. Prior research suggests adverse childhood experiences (ACEs) are an important social determinant of depression; however, few studies have examined the roles that income and race/ethnicity play in this relationship. Using a life-course perspective, this article examined whether adult family income mediated the relationship between ACEs and adult depressive symptoms among 3,106 mothers from the prospective Geographic Research of Wellbeing survey. We also examined whether race/ethnicity/immigration status moderated the relationships between ACEs, income, and symptoms. We used both mediation and moderated mediation to conduct secondary data analysis. Income significantly mediated the relationship between ACEs and depressive symptoms (b = 0.012, p = .012). The relationship between ACES and depressive symptoms was stronger among immigrant Latina participants (b = 0.25, p< .001) compared to non-Latina White participants (b = 0.12, p< .001). Practitioners should consider the role of income as a social determinant of maternal depression, promote policies that decrease income inequality, and further examine how race/ethnicity impacts the relationship between childhood adversity and maternal mental health.

Mental disorders have significant impact on the health and well-being of young people in Australia and worldwide. Intervention during adolescence is critical for reducing immediate harm and preventing the development of chronic mental disorders. This paper describes the protocol for a randomised controlled trial designed to evaluate the effectiveness of an updated version of the OurFutures Mental Health program in promoting mental health knowledge and preventing symptoms of depression and anxiety.

A two-arm cluster randomised controlled trial will be conducted from 2023 to 2024 with 1400 Year 8 students (aged 13-14years) from 14 secondary schools in Australia. Schools will be randomised to the OurFutures Mental Health intervention (n = 7), or an active control condition who will receive their usual health education curriculum (n = 7). OurFutures Mental Health is a six-lesson, online cartoon-based intervention. The intervention draws on cognitive-behavioural principles and incorporates psychoeducation, self-management, and interpersonal skill acquisition. Students will complete self-report surveys at baseline, post-intervention, and 3- and 9-months post-baseline. Primary outcomes are mental health knowledge and anxiety and depressive symptoms. Subgroup analyses will examine anxiety and depression symptoms for students reporting elevated levels of these symptoms at baseline. The primary timepoint is 3-months post-baseline. Ethical approval has been granted by the University of Sydney Human Research Ethics Committee and the study is currently under review at the State Education Research Application Process for research in government schools, and Catholic Education Dioceses in NSW. This trial is prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12622001582741).

The current study extends key models of parent emotion socialization and child outcomes by testing the interaction between maternal emotion beliefs, authoritarian parenting style, and child gender as a predictor of child behavioral difficulties. In this research, we focus on three maternal emotion beliefs (children can control their emotions, children should be given autonomy to deal with their emotions, and children's anger is valuable) and their associations with preschoolers’ conduct and peer problems, as well as potential moderation of these linkages by mothers’ authoritarian parenting and child gender. Participants included a community sample of mothers and their preschool children (N = 103). Mothers reported their emotion beliefs and authoritarian parenting, and teachers reported on children's conduct and peer problems. Child negative emotionality was assessed through an observational task and was included as a covariate in all analyses. Maternal emotion control beliefs held as the only significant main effect of parenting on child outcomes that was not dependent upon child gender. Mothers’ beliefs about the value of anger related to girls’ peer problems when mothers also reported moderate and low levels of authoritarian parenting. Clinical implications suggest a particular focus on emotion beliefs and parenting style as uniquely important for preschool girls.