Psychological trauma is an increasingly prominent construct in contemporary culture, invoked across diverse contexts of policy, practice, and public discourse. However, little is known about how laypeople conceptualise trauma in everyday life. This qualitative study explored social representations of trauma among residents of the Republic of Ireland. Twenty participants completed interviews that elaborated their associations with the term ‘trauma’. Thematic analysis identified three overarching themes, which represented trauma as (a) an individual journey, (b) a byproduct of social ills, and (c) a cultural construct. More specifically, participants viewed trauma as highly subjective, shaped by individual differences in experiences, responses and outcomes. In parallel, trauma was linked to societal-level phenomena such as war and violence, with social support positioned as key to coping and recovery. Participants were highly sensitive to the growing cultural prominence and widening uses of trauma and expressed ambivalence regarding this trend, welcoming trauma's de-stigmatisation but deploring its potential trivialisation. These findings offer original insights into how trauma is understood beyond clinical settings, informing responsible uses of the concept and ongoing debates about its cultural significance.
{"title":"What comes to mind when you hear the term ‘trauma’? A qualitative study of social representations of trauma in Ireland","authors":"Cliodhna Cadogan , Helene Joffe , Kylo Fleischer , Cliodhna O'Connor","doi":"10.1016/j.ssmmh.2026.100592","DOIUrl":"10.1016/j.ssmmh.2026.100592","url":null,"abstract":"<div><div>Psychological trauma is an increasingly prominent construct in contemporary culture, invoked across diverse contexts of policy, practice, and public discourse. However, little is known about how laypeople conceptualise trauma in everyday life. This qualitative study explored social representations of trauma among residents of the Republic of Ireland. Twenty participants completed interviews that elaborated their associations with the term ‘trauma’. Thematic analysis identified three overarching themes, which represented trauma as (a) an individual journey, (b) a byproduct of social ills, and (c) a cultural construct. More specifically, participants viewed trauma as highly subjective, shaped by individual differences in experiences, responses and outcomes. In parallel, trauma was linked to societal-level phenomena such as war and violence, with social support positioned as key to coping and recovery. Participants were highly sensitive to the growing cultural prominence and widening uses of trauma and expressed ambivalence regarding this trend, welcoming trauma's de-stigmatisation but deploring its potential trivialisation. These findings offer original insights into how trauma is understood beyond clinical settings, informing responsible uses of the concept and ongoing debates about its cultural significance.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100592"},"PeriodicalIF":2.6,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.ssmmh.2026.100586
Joshua Krohn , Mamadou Bountogo , Lucienne Ouermi , Ali Sie , Till Bärnighausen , Guy Harling
Adolescent healthcare in low-income countries receives little attention despite their growing population share, significant health challenges and the critical role of youth in shaping future health outcomes. Current research remains largely cross-sectional, limiting capacity to assess causal processes relating to care need and use. We used longitudinal data to examine adolescent need for and use of healthcare in rural Burkina Faso, to identify service gaps and thus targets for intervention.
We analyzed subjective healthcare needs and utilization among adolescents aged 12–20 in a two-round population-representative cohort in 2017–2018. Outcomes were subjective need for healthcare and levels of unmet need. We used individual fixed-effects regression to account for time-invariant characteristics and isolate time-varying effects.
Around half of 1271 adolescents reported healthcare need at each wave, mostly for malaria, injuries, and headaches. Attending school was associated with reduced perceived need (Odds Ratio [OR] 0.52, 95 % confidence interval [CI] 0.15-1.80), while injuries (OR 8.43; CI 3.34-21.30]) and bullying (OR 1.77; CI 0.93-3.40) increased it. Bullying was also associated with higher unmet need (OR 4.79; CI 1.24–18.4). Short-term demographic changes did not predict utilization.
The main time-varying factors influencing subjective health need and utilization of care were precipitating events and educational attainment, rather than sociodemographic factors. Most healthcare contacts were due to acute events and infectious diseases, not prevention programs or non-communicable diseases. Experience of bullying led to significantly higher perceived unmet need—a troubling result suggesting possible interventions both in the short- and long-term.
低收入国家的青少年保健很少受到关注，尽管这些国家的人口比例不断增长，面临重大的健康挑战，青年在塑造未来健康结果方面发挥着关键作用。目前的研究在很大程度上仍然是横向的，限制了评估与护理需求和使用有关的因果过程的能力。我们使用纵向数据来检查布基纳法索农村青少年对医疗保健的需求和使用情况，以确定服务差距，从而确定干预目标。我们分析了2017-2018年两轮人口代表性队列中12-20岁青少年的主观医疗保健需求和利用情况。结果是对医疗保健的主观需求和未满足需求的水平。我们使用个体固定效应回归来解释时不变特征并分离时变效应。在1271名青少年中，约有一半报告说，每一波都需要医疗保健，主要是疟疾、受伤和头痛。上学与感知需求减少有关（优势比[OR] 0.52, 95%可信区间[CI] 0.15-1.80），而伤害（OR 8.43; CI 3.34-21.30）和欺凌（OR 1.77; CI 0.93-3.40）则增加了感知需求。欺凌也与较高的未满足需求相关（OR 4.79; CI 1.24-18.4）。短期人口变化不能预测利用率。影响主观健康需求和护理利用的主要时变因素是突发事件和受教育程度，而不是社会人口因素。大多数医疗接触是由于急性事件和传染病，而不是预防计划或非传染性疾病。欺凌经历导致明显更高的未满足需求——这是一个令人不安的结果，表明可能采取短期和长期干预措施。
{"title":"Time-varying factors predicting adolescent healthcare needs and utilization in a rural Burkina Faso cohort: A two-way fixed effects analysis","authors":"Joshua Krohn , Mamadou Bountogo , Lucienne Ouermi , Ali Sie , Till Bärnighausen , Guy Harling","doi":"10.1016/j.ssmmh.2026.100586","DOIUrl":"10.1016/j.ssmmh.2026.100586","url":null,"abstract":"<div><div>Adolescent healthcare in low-income countries receives little attention despite their growing population share, significant health challenges and the critical role of youth in shaping future health outcomes. Current research remains largely cross-sectional, limiting capacity to assess causal processes relating to care need and use. We used longitudinal data to examine adolescent need for and use of healthcare in rural Burkina Faso, to identify service gaps and thus targets for intervention.</div><div>We analyzed subjective healthcare needs and utilization among adolescents aged 12–20 in a two-round population-representative cohort in 2017–2018. Outcomes were subjective need for healthcare and levels of unmet need. We used individual fixed-effects regression to account for time-invariant characteristics and isolate time-varying effects.</div><div>Around half of 1271 adolescents reported healthcare need at each wave, mostly for malaria, injuries, and headaches. Attending school was associated with reduced perceived need (Odds Ratio [OR] 0.52, 95<!--> <!-->% confidence interval [CI] 0.15-1.80), while injuries (OR 8.43; CI 3.34-21.30]) and bullying (OR 1.77; CI 0.93-3.40) increased it. Bullying was also associated with higher unmet need (OR 4.79; CI 1.24–18.4). Short-term demographic changes did not predict utilization.</div><div>The main time-varying factors influencing subjective health need and utilization of care were precipitating events and educational attainment, rather than sociodemographic factors. Most healthcare contacts were due to acute events and infectious diseases, not prevention programs or non-communicable diseases. Experience of bullying led to significantly higher perceived unmet need—a troubling result suggesting possible interventions both in the short- and long-term.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100586"},"PeriodicalIF":2.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.ssmmh.2026.100588
Sarah C. Haight , Jamie R. Daw , Brian W. Pence , Jaime Slaughter-Acey , Chantel L. Martin , Sarah Verbiest , Joanna Maselko
Purpose
Among a sample of people with postpartum depressive symptoms, we examine the relationship between medical mistrust and receipt of a perinatal mood and anxiety disorder (PMAD) diagnosis and postpartum mental health care by race and ethnicity.
Methods
Data are from the 2020 Postpartum Assessment of Health Survey administered at 12–14 mo postpartum across 7 US jurisdictions. The analytical sample included 454 respondents with a positive screen on the Patient Health Questionnaire-2. Self-reported measures included: medical mistrust (measured with the Group-Based Medical Mistrust Scale), PMAD diagnosis by a provider, postpartum mental health care, and race and ethnicity. Survey-weighted risk ratios (RR) were calculated for the relationship between a 1-unit increase in medical mistrust and PMAD diagnosis and care, overall and by race and ethnicity.
Results
Higher levels of medical mistrust were reported among individuals that were single, Black, Hispanic, had lower educational attainment, and public/no insurance. Increasing medical mistrust was associated with a moderately increased likelihood of PMAD diagnosis (RR: 1.2; 95 % CI: 0.8–1.0) and a reduced likelihood of receiving postpartum mental health care (RR: 0.9; 95 % CI: 0.8–1.1). The latter largely driven by the suspicion subscale (RR: 0.8; 95 % CI: 0.7–1.0). The relationship between medical mistrust and a reduced likelihood of care was strongest among Black postpartum people for both PMAD diagnosis (RR: 0.6; 95 % CI: 0.0–15.9) and care (RR: 0.9; 95 % CI: 0.4–2.3), though subgroup CIs overlapped.
Conclusion
Medical mistrust specifically related to knowledge of health disparities or feelings of suspicion may be related to racial and ethnic inequities in postpartum mental health care.
{"title":"The role of medical mistrust in racial and ethnic inequities in postpartum mental health care","authors":"Sarah C. Haight , Jamie R. Daw , Brian W. Pence , Jaime Slaughter-Acey , Chantel L. Martin , Sarah Verbiest , Joanna Maselko","doi":"10.1016/j.ssmmh.2026.100588","DOIUrl":"10.1016/j.ssmmh.2026.100588","url":null,"abstract":"<div><h3>Purpose</h3><div>Among a sample of people with postpartum depressive symptoms, we examine the relationship between medical mistrust and receipt of a perinatal mood and anxiety disorder (PMAD) diagnosis and postpartum mental health care by race and ethnicity.</div></div><div><h3>Methods</h3><div>Data are from the 2020 Postpartum Assessment of Health Survey administered at 12–14 mo postpartum across 7 US jurisdictions. The analytical sample included 454 respondents with a positive screen on the Patient Health Questionnaire-2. Self-reported measures included: medical mistrust (measured with the Group-Based Medical Mistrust Scale), PMAD diagnosis by a provider, postpartum mental health care, and race and ethnicity. Survey-weighted risk ratios (RR) were calculated for the relationship between a 1-unit increase in medical mistrust and PMAD diagnosis and care, overall and by race and ethnicity.</div></div><div><h3>Results</h3><div>Higher levels of medical mistrust were reported among individuals that were single, Black, Hispanic, had lower educational attainment, and public/no insurance. Increasing medical mistrust was associated with a moderately increased likelihood of PMAD diagnosis (RR: 1.2; 95 % CI: 0.8–1.0) and a reduced likelihood of receiving postpartum mental health care (RR: 0.9; 95 % CI: 0.8–1.1). The latter largely driven by the suspicion subscale (RR: 0.8; 95 % CI: 0.7–1.0). The relationship between medical mistrust and a reduced likelihood of care was strongest among Black postpartum people for both PMAD diagnosis (RR: 0.6; 95 % CI: 0.0–15.9) and care (RR: 0.9; 95 % CI: 0.4–2.3), though subgroup CIs overlapped.</div></div><div><h3>Conclusion</h3><div>Medical mistrust specifically related to knowledge of health disparities or feelings of suspicion may be related to racial and ethnic inequities in postpartum mental health care.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100588"},"PeriodicalIF":2.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a significant mental health service gap in Sub-Saharan Africa, with many people relying on traditional healers due to factors such as limited resources and conflict. While mental health collaborative care provision between traditional and biomedical providers is recommended, this recommendation lacks context-specific strategies for post-conflict Tigray. This study explores and identifies strategies for collaborative care provision for mental health services in the post-conflict setting of Tigray, Ethiopia.
Methods
In-depth interviews were conducted with 50 participants, including traditional healers, senior psychiatry clinicians, and their service users, in Tigray, Ethiopia. Participants were recruited through stakeholder contacts and the snowball method. Data were analysed using a thematic framework approach, with NVivo software assistance. The study adhered to the Consolidated Criteria for Reporting Qualitative Research(COREQ).
Results
Five themes emerged as strategies for collaborative mental health care between traditional and biomedical services in the post-conflict setting: (i) government and institutional support, (ii) joint training and knowledge exchange, (iii) patient-centred support, (iv) shared referral pathway, and (v) integrated intervention approach. The study highlights new insights for collaboration, such as reaching consensus on care provision despite differences in the causes of illness, involving traditional practitioners in humanitarian meetings, and implementing integration at holy water sites through trained volunteer counsellors.
Conclusion
These context-specific strategies for collaborative care may enhance mental health services in post-conflict. We recommend developing guidelines, formalising partnerships, encouraging dialogue, and prioritising the suggested strategies for effective implementation.
{"title":"Strategies for collaborative mental health care in post-conflict Tigray: A qualitative study","authors":"Kenfe Tesfay Berhe , Paul Ward , Lillian Mwanri , Hailay Abrha Gesesew","doi":"10.1016/j.ssmmh.2026.100587","DOIUrl":"10.1016/j.ssmmh.2026.100587","url":null,"abstract":"<div><h3>Background</h3><div>There is a significant mental health service gap in Sub-Saharan Africa, with many people relying on traditional healers due to factors such as limited resources and conflict. While mental health collaborative care provision between traditional and biomedical providers is recommended, this recommendation lacks context-specific strategies for post-conflict Tigray. This study explores and identifies strategies for collaborative care provision for mental health services in the post-conflict setting of Tigray, Ethiopia.</div></div><div><h3>Methods</h3><div>In-depth interviews were conducted with 50 participants, including traditional healers, senior psychiatry clinicians, and their service users, in Tigray, Ethiopia. Participants were recruited through stakeholder contacts and the snowball method. Data were analysed using a thematic framework approach, with NVivo software assistance. The study adhered to the Consolidated Criteria for Reporting Qualitative Research(COREQ).</div></div><div><h3>Results</h3><div>Five themes emerged as strategies for collaborative mental health care between traditional and biomedical services in the post-conflict setting: (i) government and institutional support, (ii) joint training and knowledge exchange, (iii) patient-centred support, (iv) shared referral pathway, and (v) integrated intervention approach. The study highlights new insights for collaboration, such as reaching consensus on care provision despite differences in the causes of illness, involving traditional practitioners in humanitarian meetings, and implementing integration at holy water sites through trained volunteer counsellors.</div></div><div><h3>Conclusion</h3><div>These context-specific strategies for collaborative care may enhance mental health services in post-conflict. We recommend developing guidelines, formalising partnerships, encouraging dialogue, and prioritising the suggested strategies for effective implementation.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100587"},"PeriodicalIF":2.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ssmmh.2025.100580
Nicole Black, Danusha Jayawardana, David W. Johnston, Trong-Anh Trinh
Rising out-of-pocket costs for psychotherapy in Australia have heightened concerns about financial barriers to mental healthcare, particularly for lower-income households, who disproportionately experience psychological distress. Using nation-wide linked administrative records of income and healthcare use, we estimate the magnitude of income-related inequity in psychotherapy use among 5.4 million individuals diagnosed with a mental health condition, and examine how such inequity has evolved over the decade from 2014 to 2023. Our findings show that income-related inequity is substantial, consistently higher among children than among adults, and has nearly doubled over the decade. By 2023, only 32% of low-income children and 40% of low-income adults accessed psychotherapy within three months of receiving a mental health treatment plan, compared with 55% among both high-income children and adults. We rule out changes in complexity of mental health disorders and the introduction of telehealth services as key drivers. We find no discernible difference by gender or age subgroups. Examination of antidepressant use reveals a growing gap in the opposite direction, with lower-income individuals increasingly reliant on medication without psychotherapy, relative to higher-income individuals. This suggests a shift towards lower-cost treatment pathways among disadvantaged groups. Our findings highlight the need for policies to address the increasing costs and other barriers to accessing psychotherapy, especially for lower-income households.
{"title":"The growing divide: Income inequities in access to mental healthcare in Australia","authors":"Nicole Black, Danusha Jayawardana, David W. Johnston, Trong-Anh Trinh","doi":"10.1016/j.ssmmh.2025.100580","DOIUrl":"10.1016/j.ssmmh.2025.100580","url":null,"abstract":"<div><div>Rising out-of-pocket costs for psychotherapy in Australia have heightened concerns about financial barriers to mental healthcare, particularly for lower-income households, who disproportionately experience psychological distress. Using nation-wide linked administrative records of income and healthcare use, we estimate the magnitude of income-related inequity in psychotherapy use among 5.4 million individuals diagnosed with a mental health condition, and examine how such inequity has evolved over the decade from 2014 to 2023. Our findings show that income-related inequity is substantial, consistently higher among children than among adults, and has nearly doubled over the decade. By 2023, only 32% of low-income children and 40% of low-income adults accessed psychotherapy within three months of receiving a mental health treatment plan, compared with 55% among both high-income children and adults. We rule out changes in complexity of mental health disorders and the introduction of telehealth services as key drivers. We find no discernible difference by gender or age subgroups. Examination of antidepressant use reveals a growing gap in the opposite direction, with lower-income individuals increasingly reliant on medication without psychotherapy, relative to higher-income individuals. This suggests a shift towards lower-cost treatment pathways among disadvantaged groups. Our findings highlight the need for policies to address the increasing costs and other barriers to accessing psychotherapy, especially for lower-income households.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100580"},"PeriodicalIF":2.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.ssmmh.2025.100584
Jennifer S. Hirsch , Gloria Fortuna , Jessie V. Ford , Alicia Jen , Jessica L. Weissman , Aarushi H. Shah , Fraidy Reiss
{"title":"Forced marriage, divorce, and the ecology of marital self-determination: findings from research with Orthodox Jews in New York","authors":"Jennifer S. Hirsch , Gloria Fortuna , Jessie V. Ford , Alicia Jen , Jessica L. Weissman , Aarushi H. Shah , Fraidy Reiss","doi":"10.1016/j.ssmmh.2025.100584","DOIUrl":"10.1016/j.ssmmh.2025.100584","url":null,"abstract":"","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100584"},"PeriodicalIF":2.6,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/j.ssmmh.2025.100579
Carmen H. Logie , Ofir Sivan , Rachel Leggett , Moses Okumu , Miranda Loutet , Frannie MacKenzie , Simon Odong Lukone , Nelson Kisubi , Lesley Gittings , Peter Kyambadde , Caetano Dorea , Manjulaa Narasimhan
Extreme weather events (EWE) contribute to heightened psychosocial stressors through complex pathways, including by worsening resource insecurities. Refugee settlements globally are disproportionately exposed to EWE compared with host national populations, yet refugees' experiences of resource insecurity-related psychosocial stressors in low-income humanitarian settings are understudied. Our study focused on understanding the lived experiences of psychosocial stressors in the context of EWE and resource insecurity among refugee youth in Bidi Bidi Refugee Settlement, Uganda. This qualitative study involved 32 walk-along interviews with a purposive sample of refugee youth aged 16–24 (16 men, 16 women); youth led the interviewer to 1–3 places where they obtained food, water, and/or sanitation resources, discussed the place's meaning and impact on wellbeing, and took photos. We also conducted 12 in-depth interviews with key informants with expertise in refugee youth wellbeing, EWE, and/or resource security. We conducted framework thematic analysis informed by resource scarcity and water insecurity-related distress frameworks. Participant narratives reflected four key themes regarding linkages between EWE, resource insecurities, and psychosocial distress: 1) material deprivation and uncertainty (sub-themes: drought-related food and water insecurity; flooding-related infrastructure and agricultural damage); 2) shame of social failure (sub-themes: sanitation insecurity stressors; unemployment and food insecurity distress and related substance use); 3) interpersonal conflict, including multi-level violence (sub-themes: increased violence; concerns about crime and theft); and 4) coping and asset management strategies (sub-themes: social and economic infrastructure; social capital; household relations). Together findings suggest the need for integrating psychosocial support within social and economic opportunities and poverty reduction with refugee youth.
{"title":"Psychosocial stressors related to extreme weather events and multiple resource insecurities: qualitative insights from refugee youth in an Ugandan humanitarian setting","authors":"Carmen H. Logie , Ofir Sivan , Rachel Leggett , Moses Okumu , Miranda Loutet , Frannie MacKenzie , Simon Odong Lukone , Nelson Kisubi , Lesley Gittings , Peter Kyambadde , Caetano Dorea , Manjulaa Narasimhan","doi":"10.1016/j.ssmmh.2025.100579","DOIUrl":"10.1016/j.ssmmh.2025.100579","url":null,"abstract":"<div><div>Extreme weather events (EWE) contribute to heightened psychosocial stressors through complex pathways, including by worsening resource insecurities. Refugee settlements globally are disproportionately exposed to EWE compared with host national populations, yet refugees' experiences of resource insecurity-related psychosocial stressors in low-income humanitarian settings are understudied. Our study focused on understanding the lived experiences of psychosocial stressors in the context of EWE and resource insecurity among refugee youth in Bidi Bidi Refugee Settlement, Uganda. This qualitative study involved 32 walk-along interviews with a purposive sample of refugee youth aged 16–24 (16 men, 16 women); youth led the interviewer to 1–3 places where they obtained food, water, and/or sanitation resources, discussed the place's meaning and impact on wellbeing, and took photos. We also conducted 12 in-depth interviews with key informants with expertise in refugee youth wellbeing, EWE, and/or resource security. We conducted framework thematic analysis informed by resource scarcity and water insecurity-related distress frameworks. Participant narratives reflected four key themes regarding linkages between EWE, resource insecurities, and psychosocial distress: 1) material deprivation and uncertainty (sub-themes: drought-related food and water insecurity; flooding-related infrastructure and agricultural damage); 2) shame of social failure (sub-themes: sanitation insecurity stressors; unemployment and food insecurity distress and related substance use); 3) interpersonal conflict, including multi-level violence (sub-themes: increased violence; concerns about crime and theft); and 4) coping and asset management strategies (sub-themes: social and economic infrastructure; social capital; household relations). Together findings suggest the need for integrating psychosocial support within social and economic opportunities and poverty reduction with refugee youth.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100579"},"PeriodicalIF":2.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.ssmmh.2025.100582
Xinxin Zhu , Yi Yang , Helen Wright , Lydia Gabriela Speyer , Marie Allitt , Ingrid Obsuth , Patrick Errington , Aja Louise Murray
There has been considerable recent debate surrounding the effects of social media use and adolescents' mental health. A key source of controversy is whether observed associations might be confounded by ‘third variables’ (which influence both social media use and mental health). To address this, we used counterfactual analysis to account for measured confounding. This approach provides estimates of causal effects by comparing observed outcomes with those that would be expected under an alternative exposure condition. We employed it to evaluate the link between social media use (including messaging and visiting social networking websites) at ages 11 and 14 and later mental health issues (including emotional symptoms, self-harm, and/or suicide attempts) at ages 14 and 17. Data was from the UK Millennium Cohort Study (MCS), a nationally representative sample. The study was conducted with the input of a young persons' advisory group, who informed our prioritization of the study research question, helped interpret findings, and identify study limitations. Inverse probability of treatment weighting (IPTW) analyses indicated no significant effects of social media use frequency at age 11 (defined as use on most days) or time spent at age 14 (≥2 h per weekday) on emotional problems or self-harm at age 14 or 17, respectively (analytic n = 3036–4419). The only exception was significant association between higher time spent on social media at age 14 and lifetime suicide attempts at age 17. These findings highlight the importance of considering potential confounders when examining social media use effects. Given that frequency and time-based measures are unlikely to capture the complexity of this association, we recommend future research also apply similar approaches utilizing more nuanced measures.
{"title":"The association between social media use and mental health symptoms in middle adolescence: A counterfactual analysis","authors":"Xinxin Zhu , Yi Yang , Helen Wright , Lydia Gabriela Speyer , Marie Allitt , Ingrid Obsuth , Patrick Errington , Aja Louise Murray","doi":"10.1016/j.ssmmh.2025.100582","DOIUrl":"10.1016/j.ssmmh.2025.100582","url":null,"abstract":"<div><div>There has been considerable recent debate surrounding the effects of social media use and adolescents' mental health. A key source of controversy is whether observed associations might be confounded by ‘third variables’ (which influence both social media use and mental health). To address this, we used counterfactual analysis to account for measured confounding. This approach provides estimates of causal effects by comparing observed outcomes with those that would be expected under an alternative exposure condition. We employed it to evaluate the link between social media use (including messaging and visiting social networking websites) at ages 11 and 14 and later mental health issues (including emotional symptoms, self-harm, and/or suicide attempts) at ages 14 and 17. Data was from the UK Millennium Cohort Study (MCS), a nationally representative sample. The study was conducted with the input of a young persons' advisory group, who informed our prioritization of the study research question, helped interpret findings, and identify study limitations. Inverse probability of treatment weighting (IPTW) analyses indicated no significant effects of social media use frequency at age 11 (defined as use on most days) or time spent at age 14 (≥2 h per weekday) on emotional problems or self-harm at age 14 or 17, respectively (analytic n = 3036–4419). The only exception was significant association between higher time spent on social media at age 14 and lifetime suicide attempts at age 17. These findings highlight the importance of considering potential confounders when examining social media use effects. Given that frequency and time-based measures are unlikely to capture the complexity of this association, we recommend future research also apply similar approaches utilizing more nuanced measures.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100582"},"PeriodicalIF":2.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.ssmmh.2025.100583
Mia Akiba , Stephanie J. Lewis , Tsitsi Mawere , Alli Roshni , Karen Muchezana , Wilson Mutsvuke , Walter Mangezi , Conall O'Cleirigh , Sharli Paphitis , Nick Grey , Tarisai Bere , Melanie A. Abas
{"title":"Trauma-related experiences among people living with HIV in Zimbabwe: a qualitative study","authors":"Mia Akiba , Stephanie J. Lewis , Tsitsi Mawere , Alli Roshni , Karen Muchezana , Wilson Mutsvuke , Walter Mangezi , Conall O'Cleirigh , Sharli Paphitis , Nick Grey , Tarisai Bere , Melanie A. Abas","doi":"10.1016/j.ssmmh.2025.100583","DOIUrl":"10.1016/j.ssmmh.2025.100583","url":null,"abstract":"","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"9 ","pages":"Article 100583"},"PeriodicalIF":2.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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