SSM. Mental health最新文献

State-level variation in the prevalence of child psychopathology symptoms in the US: Results from the ABCD study 美国各州儿童精神病理症状流行率的差异：ABCD 研究的结果

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-10-28 DOI: 10.1016/j.ssmmh.2024.100361

Objective

To estimate the prevalence of clinically meaningful youth mood, anxiety, behavioral, and attention symptoms across US states.

Method

Data are drawn from the Adolescent Brain Cognitive Development (ABCD) study baseline wave, which included 11,876 children ages 9–10. Statistical weighting strategies generated projected state-specific prevalence estimates for the 17 states where ABCD collected data based on state socio-demographics. Twenty dimensions of mental health were assessed with the Child Behavior Checklist using recommended cut-scores to assess clinical and sub-threshold symptoms.

Results

Psychopathology symptom prevalence varied by state and outcome. Projected prevalence of internalizing problems ranged from 11.0% [95% CI: 9.8%, 12.2%; Oklahoma] to 7.9% [95% CI: 6.9%, 9.0%; Maryland] across states. Projected prevalence of externalizing problems ranged from 6.9% [95% CI: 6.1%, 7.8%; South Carolina] to 4.5% [95% CI: 3.7%, 5.4%; California]. Regions with high symptoms included sections of the South (e.g., Oklahoma, South Carolina) and Vermont. Conduct problems had the most variability across states (i.e., greatest state-level prevalence 91% higher than the lowest). Attention problems had the least variability across states (greatest state-level prevalence 26% higher than the lowest).

Conclusions

Clinically meaningful psychopathology symptoms are common in children across the US, with substantial state-level variability in prevalence. Understanding variability in the prevalence of psychopathology symptoms across the US can help to inform resource allocation to increase the availability of youth mental health services.

方法数据来自青少年大脑认知发展（ABCD）研究基线波，其中包括 11,876 名 9-10 岁的儿童。在 ABCD 收集数据的 17 个州中，根据各州的社会人口统计数据，采用统计加权策略得出了各州的患病率预测值。使用儿童行为检查表对心理健康的 20 个方面进行评估，采用建议的切分分数来评估临床症状和阈值以下症状。各州内化问题的预计流行率从 11.0% [95% CI：9.8%，12.2%；俄克拉荷马州] 到 7.9% [95% CI：6.9%，9.0%；马里兰州] 不等。外化问题的预计流行率从 6.9% [95% CI：6.1%，7.8%；南卡罗来纳州] 到 4.5% [95% CI：3.7%，5.4%；加利福尼亚州] 不等。症状较多的地区包括南方部分地区（如俄克拉荷马州、南卡罗来纳州）和佛蒙特州。行为问题在各州之间的差异最大（即州一级的最高流行率比最低流行率高出 91%）。结论在美国各州，有临床意义的精神病理学症状在儿童中很常见，各州的患病率差异很大。了解美国各州精神病理症状流行率的差异有助于为资源分配提供依据，从而增加青少年心理健康服务的可获得性。

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引用次数: 0

Perceptions around occupational mental well-being of community health workers and an intervention package for its promotion: A mixed-methods study in rural Chiapas, Mexico 社区卫生工作者对职业心理健康的看法及促进心理健康的一揽子干预措施：墨西哥恰帕斯州农村地区的混合方法研究

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-10-26 DOI: 10.1016/j.ssmmh.2024.100360

Background

The challenging working conditions experienced by community health workers (CHWs) have an impact on their mental health, as detected by the NGO Compañeros En Salud (CES) in rural Mexico. In response to this situation, CES designed through a participatory process a package of interventions to promote the mental well-being of CHWs, beginning implementation in 2021. The objective of the present study was to learn how CES CHWs' work affects their mental well-being and to evaluate the intervention package to promote CHWs’ mental well-being implemented by CES.

Methods

In June–August 2023, 52 CHWs from the CES-supported communities participated in the study, responding to a survey and participating in 10 focus group discussions. Quantitative data were analyzed using statistical descriptive analysis and qualitative data using thematic analysis.

Findings

Participants highlighted the impact on their communities as one of the main aspects of their job that contribute positively to their mental well-being, as well as the challenging work-life balance as one of the main aspects that contribute negatively. As for the interventions, most participants considered them significant and positive for their mental well-being, highlighting positive aspects such as the possibility of creating community with their peers or a feeling of self-efficacy. However, the access to interventions was uneven among participants and most interventions presented areas for improvement, such as the periodicity of psychological distress screening or the response time to material needs.

Conclusions

Efforts to support CHW well-being in the areas they signal as needs can impact their experiences around work and their perceived well-being. Access to work materials, preparedness on clinical topics, and relationships with their teams are key areas that may have a bearing on CHWs' emotional and mental well-being. Interventions aimed at these areas can positively impact CHWs’ self-efficacy, their community with each other, and their interactions with patients.

背景正如非政府组织 "Compañeros En Salud（CES）"在墨西哥农村地区所发现的那样，社区医疗工作者（CHWs）所经历的具有挑战性的工作条件对他们的心理健康产生了影响。针对这种情况，CES 通过参与式过程设计了一套干预措施，以促进社区卫生工作人员的心理健康，并于 2021 年开始实施。本研究的目的是了解 CES 社区保健工作者的工作如何影响他们的心理健康，并对 CES 实施的促进社区保健工作者心理健康的一揽子干预措施进行评估。研究结果参与者强调，对社区的影响是其工作中对心理健康有积极影响的主要方面之一，而具有挑战性的工作与生活平衡则是对心理健康有消极影响的主要方面之一。至于干预措施，大多数参与者认为这些措施对其心理健康具有重要和积极的意义，并强调了一些积极的方面，如与同龄人建立社区的可能性或自我效能感。然而，参与者获得干预措施的情况参差不齐，大多数干预措施都有需要改进的地方，如心理困扰筛查的周期性或对物质需求的响应时间。工作材料的获取、临床课题的准备以及与团队的关系是可能影响社区保健工作者情绪和心理健康的关键领域。针对这些方面的干预措施可以对社区保健工作者的自我效能感、他们之间的社区关系以及他们与患者之间的互动产生积极影响。

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引用次数: 0

The ties that bind: Understanding the mental health consequences of the Windrush Scandal and hostile immigration policies on survivors in the UK 紧密联系：了解 Windrush 丑闻和敌对移民政策对英国幸存者心理健康的影响

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-10-10 DOI: 10.1016/j.ssmmh.2024.100352

The Home Office Windrush Scandal of 2018 has had major implications for the wellbeing of survivors and is thought to have affected more than 15,000 individuals. The Government led compensation scheme to provide retribution to those impacted has been consistently argued as insufficient, in part linked to under appreciation of mental health consequences of the scandal. However, there is limited evidence which documents the nature of mental health issues that survivors and families have faced. This need for further evidence intersects with the need to protect a highly vulnerable community from further traumatisation. Our study contributes to this gap through a content analysis of survivor testimonies (n = 96) published in publicly available media sources between 2017 and 2023. Analysis explored social pathways to the development of mental distress and experiences of potential mental health consequences. Our analysis was informed by a complex trauma and complex racial trauma framework. Findings demonstrate that the scandal disrupted numerous social domains linked to livelihoods and positive wellbeing, driving survivors into homelessness, and experiences of dehumanization within state systems. This shaped survivors’ experiences of emotional distress, resulting in symptoms linked to depression, chronic stress, and anxiety disorders. Our work illuminates new details about the nature of trauma faced by survivors. Findings suggest the need for systems that provide targeted mental health supports that also address social disruption, to fully respond to the harms created by the scandal.

2018 年的内政部 "拉什风 "丑闻对幸存者的福祉产生了重大影响，据认为影响人数超过 15000 人。政府主导的补偿计划为受影响者提供了补偿，但一直被认为是不够的，部分原因与对丑闻造成的心理健康后果认识不足有关。然而，记录幸存者及其家人所面临的心理健康问题性质的证据非常有限。对进一步证据的需求与保护极易受到伤害的群体免受进一步创伤的需求交织在一起。我们的研究通过对 2017 年至 2023 年间公开媒体发表的幸存者证词（n = 96）进行内容分析，弥补了这一空白。分析探讨了精神痛苦发展的社会途径以及潜在精神健康后果的经历。我们的分析参考了复杂创伤和复杂种族创伤框架。研究结果表明，丑闻扰乱了与生计和积极福祉相关的众多社会领域，导致幸存者无家可归，并在国家系统中经历了非人化的体验。这影响了幸存者的情绪困扰体验，导致了与抑郁、慢性压力和焦虑症相关的症状。我们的工作揭示了幸存者所面临的创伤本质的新细节。研究结果表明，为了全面应对丑闻造成的伤害，有必要建立一个系统，提供有针对性的心理健康支持，同时解决社会混乱问题。

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引用次数: 0

Barriers and enablers to a coordinated MHPSS response in Lebanon: A case study of the MHPSS Taskforce 黎巴嫩协调应对 MHPSS 的障碍和促进因素：MHPSS 工作队案例研究

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-10-09 DOI: 10.1016/j.ssmmh.2024.100354

During humanitarian crises, under-resourced and overstretched health systems may not be able to fully meet mental health and psychosocial support (MHPSS) needs of affected populations, including refugees, internally displaced persons and host communities. Health system governance is vital to humanitarian health response, but there has been little research on this, particularly for MHPSS. We present a case study of a national MHPSS coordination mechanism (the MHPSS Taskforce) in Lebanon, a country which has experienced multiple crises and hosts over 2 million refugees. The aim was to explore the barriers and enablers facing the MHPSS Taskforce in responding to the needs of displaced and host populations in Lebanon. Interviews were conducted with 34 key stakeholders, including Taskforce members, representatives from non-governmental organisations, United Nations agencies, and government Ministries. Our findings show that the positioning of MHPSS within the humanitarian cluster system acts as a barrier to mounting an effective response, with the MHPSS Taskforce sometimes siloed rather than integrated across clusters. Coordination within the Taskforce was reported to be effective in some respects, but limited by a lack of clarity about its decision-making processes, affiliation, mandate, and inclusion of regional perspectives and key groups such as mental health services users in Lebanon. While the technical capacity of the Taskforce is strong, limited funding and staffing were seen to impact its capacity to effectively oversee the MHPSS response in Lebanon. Key recommendations include: the need for stronger mechanisms and operating procedures for interagency and inter-sectoral collaboration on MHPSS within the humanitarian cluster system; greater clarity on the role of the Taskforce and key Taskforce actors, streamlined reporting channels and greater inclusion of diverse perspectives, particularly mental health service users; and greater financial and human resources within coordination mechanisms to support the national MHPSS response in Lebanon.

在人道主义危机期间，资源不足和过度紧张的卫生系统可能无法完全满足受影响人群（包括难民、境内流离失所者和收容社区）的心理健康和社会心理支持（MHPSS）需求。医疗系统治理对人道主义医疗响应至关重要，但这方面的研究却很少，尤其是针对心理健康和社会心理支持系统的研究。黎巴嫩经历了多次危机，收容了 200 多万难民，我们将对黎巴嫩的国家 MHPSS 协调机制（MHPSS 工作组）进行案例研究。研究的目的是探讨黎巴嫩的 MHPSS 工作组在应对流离失所者和收容人口的需求时所面临的障碍和有利因素。对 34 个主要利益相关方进行了访谈，包括工作队成员、非政府组织代表、联合国机构和政府部委。我们的调查结果表明，在人道主义分组系统中，MHPSS 的定位是开展有效响应的障碍，MHPSS 工作队有时是孤立的，而不是跨分组整合的。据报告，特别工作组内部的协调在某些方面是有效的，但由于其决策过程、隶属关系、任务授权、地区视角和关键群体（如黎巴嫩的心理健康服务使用者）的纳入等方面不够明确，因而受到限制。虽然特别工作组的技术能力很强，但有限的资金和人员编制影响了其有效监督黎巴嫩精神健康和社会服务部门应对措施的能力。主要建议包括：需要在人道主义群组系统内建立更强有力的机制和运作程序，以促进机构间和部门间在 MHPSS 方面的合作；进一步明确特别工作组和特别工作组主要参与者的作用，简化报告渠道，更多地纳入不同的观点，特别是心理健康服务使用者的观点；在协调机制内提供更多的财政和人力资源，以支持黎巴嫩全国的 MHPSS 应对措施。

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引用次数: 0

Understanding depression and the PHQ-9 items among people living with HIV: A multiple methods qualitative study in Yaoundé, Cameroon 了解艾滋病毒感染者中的抑郁症和 PHQ-9 项目：喀麦隆雅温得多重方法定性研究

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-10-05 DOI: 10.1016/j.ssmmh.2024.100353

People living with HIV (PLWH) are disproportionately affected by depression, which often remains underdiagnosed and untreated, negatively impacting quality of life and treatment outcomes. Low resource settings often lack clinical professionals to identify depression, therefore screening tools such as the PHQ-9 allow for broader depression screening. This qualitative study among PLWH in Yaoundé Cameroon aimed to a) explore local understandings of depression and mental distress and b) assess comprehension and interpretation of the PHQ-9 items and response categories.

This study was nested in a larger study that assessed performance of the PHQ-9 among PLWH in Central, East, and West Africa. In Yaoundé, Cameroon, 30 in-depth interviews (IDIs) and 24 cognitive interviews (CIs) were conducted with PLWH to explore how depression is experienced and to examine understanding and interpretation of the PHQ-9 items. Thematic analysis was used to identify emergent themes across IDIs focusing on shared understandings of depression. An interpretivist content analysis of CIs incorporated understandings of PHQ-9 items into cognitive processes of interpretation, retrieval, judgment, and response formulation.

Out of 54 unique study participants, 15% (n = 8) had depressive symptoms (PHQ-9 score >9). The PHQ-9 items related to somatic manifestations of depression were understood as intended by most participants, while other items were not consistently understood and interpreted. “Thinking too much” and similar cognitive manifestations were central for local understandings of depression. Cognitive and somatic symptoms commonly intertwined and were often linked to experiences living with HIV. Local understanding of depression may not align with Western defined depression criteria, and symptoms related to HIV may conflate symptoms of depression. Incorrect interpretations of almost half of the PHQ-9 items suggests this tool may have limited validity in PLWH, and warrants the need for further testing and adaptation. Further research should be done to develop culturally relevant screening tools among PLWH.

艾滋病病毒感染者（PLWH）受抑郁症的影响尤为严重，而抑郁症往往得不到及时诊断和治疗，从而对生活质量和治疗效果产生负面影响。资源匮乏的环境往往缺乏识别抑郁症的临床专业人员，因此，PHQ-9 等筛查工具可用于更广泛的抑郁症筛查。这项针对喀麦隆雅温得 PLWH 的定性研究旨在：a) 探索当地人对抑郁和精神痛苦的理解；b) 评估对 PHQ-9 项目和反应类别的理解和解释。在喀麦隆雅温得，研究人员对 PLWH 进行了 30 次深度访谈 (IDI) 和 24 次认知访谈 (CI)，以探索抑郁症患者的经历，并检查他们对 PHQ-9 项目的理解和解释。主题分析用于识别 IDI 中出现的主题，重点是对抑郁症的共同理解。对 CI 的解释性内容分析将对 PHQ-9 项目的理解纳入了解释、检索、判断和做出反应的认知过程中。在 54 名独特的研究参与者中，15%（n = 8）有抑郁症状（PHQ-9 分数为 9）。大多数参与者都能理解与抑郁的躯体表现有关的 PHQ-9 项目，但对其他项目的理解和解释却不一致。"想得太多 "和类似的认知表现是当地人理解抑郁症的核心。认知症状和躯体症状通常交织在一起，并经常与感染艾滋病毒的经历联系在一起。当地人对抑郁症的理解可能与西方定义的抑郁症标准不一致，与 HIV 相关的症状可能会与抑郁症状混淆。对 PHQ-9 中近一半项目的不正确解释表明，该工具在 PLWH 中的有效性可能有限，因此需要进一步测试和调整。应在 PLWH 中开展进一步研究，开发与文化相关的筛查工具。

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引用次数: 0

Fostering resilient recovery: An intervention for disaster-affected teachers in Indonesia 培养恢复能力：针对印度尼西亚受灾教师的干预措施

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-10-05 DOI: 10.1016/j.ssmmh.2024.100355

Disasters leave survivors at heighted risk of negative psychological consequences. Teachers require post-disaster psychosocial support, given their added responsibility for supporting their students' recovery. However, alongside coping with their own mental health, teachers often lack training to support students psychologically. This study addresses this gap by detailing an intervention designed to foster resilient recovery among secondary school teachers in Central Sulawesi, Indonesia, to enhance their ability to support both themselves and their students after a devastating earthquake/tsunami.

Teachers (n = 37) from three disaster-affected schools participated in a one-day workshop exploring collective strengths and strategies to develop their own and their students’ post-disaster resilience, featuring the Tree of Life activity. Impact was evaluated using a pre-post intervention design. Findings from a three month follow up demonstrated significant improvements across various resilience-related measures, including personal resilience, community resilience, social support, adaptive coping strategies, psychological help seeking, earthquake anxiety, post-traumatic stress, complex post-traumatic stress and fatalism. Open-ended survey responses indicated that most teachers reporting subjective improvements in their own recovery and their capacity to support students psychologically. This study emphasises the importance of creating teacher interventions underpinned by disaster recovery theory, which offer practical skills to foster post-disaster psychosocial recovery. While the intervention exhibits promising initial results, future research would benefit from an evaluation using a randomised control group.

灾难使幸存者面临更高的负面心理后果风险。教师需要灾后社会心理支持，因为他们更有责任支持学生的康复。然而，在应对自身心理健康问题的同时，教师往往缺乏为学生提供心理支持的培训。为了弥补这一不足，本研究详细介绍了一项旨在促进印度尼西亚中苏拉威西省中学教师灾后恢复能力的干预措施，以提高他们在毁灭性地震/海啸发生后为自己和学生提供支持的能力。来自三所受灾学校的教师（n = 37）参加了为期一天的工作坊，探索集体力量和策略，以发展他们自己和学生的灾后恢复能力，其中包括生命之树活动。采用前-后干预设计对活动效果进行了评估。为期三个月的跟踪调查结果表明，与抗灾能力相关的各项指标均有明显改善，包括个人抗灾能力、社区抗灾能力、社会支持、适应性应对策略、心理求助、地震焦虑、创伤后应激反应、复杂创伤后应激反应和宿命论。开放式问卷调查结果显示，大多数教师主观上认为自己的恢复能力和为学生提供心理支持的能力有所提高。这项研究强调了以灾后恢复理论为基础制定教师干预措施的重要性，这些干预措施提供了促进灾后社会心理恢复的实用技能。虽然干预措施取得了可喜的初步成果，但采用随机对照组进行评估将有利于今后的研究。

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引用次数: 0

Treatment resistance in schizophrenia and depression as an interactive kind: Mapping the development of a classification through Meta-Narrative review 精神分裂症和抑郁症的治疗阻力是一种交互作用：通过元叙事回顾绘制分类发展图

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-09-28 DOI: 10.1016/j.ssmmh.2024.100350

Despite ongoing attempts to delineate and name treatment resistance (TR) in psychiatry, the term is increasingly deployed across diagnostic categories. Still, what it is that constitutes TR remains unclear and in flux. Through a meta-narrative review, we construct a sociohistorical map of the concept of TR as it is employed in schizophrenia (TRS) and major depressive disorders (TRD). We track debates about TR, identify underlying assumptions and influencing factors that shape how the concept has evolved over time, and consider the intended and unintended consequences of its conceptualization. We develop our findings as three unique threads that, braided together, offer insight into TR as an interactive kind. Each thread analyzes and plays with the notion of heterogeneity, which arises in the literature as both a theme and a problem to be solved. Thread one looks at prevailing controversies surrounding the definition of TR. Here, heterogeneity arises in relation to how TR is delineated. We also consider the notion of “pseudoresistance,” a novel concept that functions to manage and contain heterogeneity, defining the boundaries of TR through its exclusions. Thread two explores the range of actors whose interests and practices are coordinated to shape TR as a concept: the pharmaceutical industry, academic psychiatry, clinicians, and health systems. Each group has its own interests and orientations: a heterogenous range of actors contributing to the thing that TR is. Thread three examines the intended and unintended consequences that attempts to conceptualize TR have yielded, including a reification of the biomedical paradigm and the personification of TR. This paper offers a systematic approach to thinking about similarities, differences, particularities and tensions embedded within TR to understand the politics and possibilities of the concept.

尽管精神病学界一直在尝试对治疗抵抗（TR）进行界定和命名，但这一术语越来越多地被用于各种诊断类别。然而，TR 的构成要素仍不明确，且不断变化。通过元叙事回顾，我们构建了精神分裂症（TRS）和重度抑郁障碍（TRD）中使用的 TR 概念的社会历史地图。我们追踪了有关 TR 的争论，确定了影响这一概念随时间演变的基本假设和影响因素，并考虑了其概念化的预期和非预期后果。我们的研究结果分为三条独特的主线，三条主线交织在一起，让人们深入了解作为一种互动类型的精神障碍。每条线索都对异质性概念进行了分析和探讨，在文献中，异质性既是一个主题，也是一个有待解决的问题。第一条主线探讨了围绕 "TR "定义的普遍争议。在这里，异质性与如何界定 TR 有关。我们还考虑了 "伪抵抗 "的概念，这是一个新颖的概念，其作用是管理和遏制异质性，通过排除异质性来界定 TR 的边界。主题二探讨了一系列参与者，他们的利益和实践相互协调，共同塑造了 "TR "这一概念：制药业、精神病学学术界、临床医生和医疗系统。每个群体都有自己的利益和取向：一系列不同的参与者对 TR 的形成做出了贡献。第三部分探讨了试图将 TR 概念化所产生的预期和非预期后果，包括生物医学范式的重构和 TR 的人格化。本文提供了一种系统的方法来思考 TR 的相似性、差异性、特殊性和紧张性，从而理解这一概念的政治性和可能性。

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引用次数: 0

The use of virtual reality in the treatment of mental disorders such as phobias and post-traumatic stress disorder 利用虚拟现实技术治疗恐惧症和创伤后应激障碍等精神疾病

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-09-26 DOI: 10.1016/j.ssmmh.2024.100351

Mental disorders, such as phobias and post-traumatic stress disorder (PTSD), are a serious health problem that significantly impacts people's quality of life. These disorders can significantly impair the quality of life of patients, so studying ways to treat them using modern methods is important and relevant. The purpose of this study is to evaluate the effectiveness and potential of using virtual reality (VR) technology in the treatment of phobias and PTSD. The methods used in the study include analytical, comparative, and systematization methods. The study has shown that cognitive behavioural therapy and exposure therapy are the main treatments for these disorders. The use of VR in the treatment of mental disorders, including phobias and PTSD, opens up new opportunities for safe and effective exposure to stressful stimuli. It was found that the benefits of using VR in the treatment of mental disorders include safe exposure, an individualized approach to treatment, and the ability to create realistic simulations of stressful situations. The study confirmed that the use of VR in the treatment of phobias allows patients to gradually get used to phobic stimuli and change their negative perceptions and reactions to them. The use of VR in the treatment of PTSD has significant potential, allowing the application of various techniques, including exposure, gradual desensitization, cognitive behavioural therapy, therapeutic recovery, meditation, and relaxation, to alleviate the symptoms of the disorder and improve the quality of life of patients. The findings of the study can serve as a basis for improving clinical practice in psychotherapy and psychiatry, allowing for more effective and individualized care for patients with disorders.

恐惧症和创伤后应激障碍（PTSD）等精神障碍是严重影响人们生活质量的健康问题。这些疾病会严重影响患者的生活质量，因此研究如何利用现代方法治疗这些疾病具有重要的现实意义。本研究的目的是评估使用虚拟现实（VR）技术治疗恐惧症和创伤后应激障碍的有效性和潜力。研究采用的方法包括分析法、比较法和系统化法。研究表明，认知行为疗法和暴露疗法是治疗这些疾病的主要方法。利用虚拟现实技术治疗恐惧症和创伤后应激障碍等精神障碍，为安全有效地暴露于应激刺激开辟了新的机会。研究发现，使用虚拟现实技术治疗精神障碍的好处包括安全暴露、个性化的治疗方法以及能够创造逼真的应激情境模拟。研究证实，使用 VR 治疗恐惧症可以让患者逐渐适应恐惧症刺激，并改变他们对这些刺激的负面看法和反应。使用 VR 治疗创伤后应激障碍具有巨大的潜力，可以应用各种技术，包括暴露、逐渐脱敏、认知行为疗法、治疗恢复、冥想和放松，以减轻该障碍的症状，提高患者的生活质量。研究结果可作为改进心理治疗和精神病学临床实践的依据，从而为失调症患者提供更有效和个性化的护理。

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引用次数: 0

Intersectional trends in poor mental health and health inequities across the US 全美心理健康状况不佳和健康不平等的交叉趋势

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-09-03 DOI: 10.1016/j.ssmmh.2024.100349

Though mental distress poses a large and growing threat to population health, our understanding of how its social distribution has changed over time and what these changes imply for mental health equity is limited. To address this, we use data from the Behavioral Risk Factor Surveillance System to non-parametrically describe how age-standardized prevalence of frequent mental distress (FMD) and social inequities in FMD have changed in the United States between 1993 and 2019 for intersectional social groups defined by ethnicity, race, sex, educational attainment, and household poverty status. We find that age-standardized FMD prevalence has increased for almost all social groups, that health inequities between more and less privileged groups have mostly widened in absolute terms but narrowed relatively, and that relying solely on common group FMD summaries masks substantial heterogeneity across intersectional subgroups. Our findings show an urgent need to address the sociopolitical determinants of mental distress, prioritizing policies which would address the growing inequitable burden experienced by those less privileged.

尽管精神痛苦对人口健康构成了巨大且日益严重的威胁，但我们对其社会分布如何随时间推移而发生变化以及这些变化对精神健康公平的影响的了解却很有限。为了解决这个问题，我们利用行为风险因素监测系统的数据，以非参数的方式描述了 1993 年至 2019 年期间，在美国，根据民族、种族、性别、教育程度和家庭贫困状况界定的交叉社会群体中，频繁精神痛苦（FMD）的年龄标准化流行率和 FMD 的社会不平等是如何变化的。我们发现，几乎所有社会群体的年龄标准化 FMD 患病率都有所上升，特权较多群体与特权较少群体之间的健康不平等在绝对值上大多有所扩大，但相对有所缩小，而且仅仅依靠共同群体的 FMD 总结掩盖了跨部门亚群体之间的实质性异质性。我们的研究结果表明，亟需解决精神痛苦的社会政治决定因素，优先制定政策，解决弱势群体所承受的日益加重的不公平负担。

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引用次数: 0

Unstable states and the biologization of mental illness 不稳定状态和精神疾病的生物化

IF 4.1 Q1 PSYCHIATRY

SSM. Mental health

Pub Date : 2024-07-31 DOI: 10.1016/j.ssmmh.2024.100348

We critically examine how biological narratives of mental illness mediate relations between personal experiences and socio-structural conditions of distress in crisis contexts. Using three case studies of contemporary crises in Russia, the Republic of Cameroon, and Bangladesh, we showcase the ways in which biological meanings of mental illness carry political and structural significance as authorities employ “biologization” for political ends. In Russia, biologization is strategically useful to authorities seeking to control a populace, as chronic “conditions” can be “treated” indefinitely. In Cameroon, state psychiatrists in Yaoundé incentivize patient citizenship through biological frameworks of illness and intervention. In Bangladesh, the embodied presence of Rohingya refugees is a medium by which they can engage politically; therapeutic intervention becomes a site of political consensus in which Rohingya enact a “fictive biological citizenship.” Biologization of mental illness forms a basis for reinforcing or challenging the power of the state and the meaning of citizenship in distinct ways across these three contexts, highlighting the importance of attending to its political implications as it is invoked in frameworks of diagnosis, explanation, prognosis, and treatment in global contexts of ostensible crisis.

我们以批判的眼光审视了在危机背景下，精神病的生物学叙事是如何调节个人经历与社会结构困境之间的关系的。通过对俄罗斯、喀麦隆共和国和孟加拉国当代危机的三个案例研究，我们展示了当当局为政治目的而采用 "生物化 "时，精神疾病的生物学意义如何具有政治和结构意义。在俄罗斯，"生物化 "在战略上有利于当局控制民众，因为慢性 "疾病 "可以被无限期地 "治疗"。在喀麦隆，雅温得的国立精神病学家通过疾病和干预的生物学框架来激励病人的公民权。在孟加拉国，罗兴亚难民的肉身存在是他们参与政治的媒介；治疗干预成为政治共识的场所，罗兴亚人在其中建立了 "虚构的生物公民身份"。在这三种背景下，精神疾病的生物化以不同的方式构成了加强或挑战国家权力和公民权意义的基础，这突出了在全球表面危机的背景下，当诊断、解释、预后和治疗框架中援引生物化时，关注其政治含义的重要性。

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引用次数: 0