SSM. Mental health最新文献

In the United States, there exists a large disparity in the diagnosis of schizophrenia between Black and White individuals. Some of the symptoms associated with schizophrenia, such as agitation, delusions, and non-compliance, were previously linked to a now-discontinued condition known as “Protest Psychosis.” This proposed subtype of schizophrenia diagnosis emerged during the 1950s and 1960s in response to racial tensions during the Civil Rights movement and preceded an increase in schizophrenia diagnosis among Black populations, potentially leading to racial disparities in this psychiatric condition that continue to permeate the modern context.

In May 2020, the police killing of George Floyd sparked widespread protests through the Black Lives Matter Movement. Given the historical precedence of “protest psychosis” in response to the Civil Rights Movement, we examined disparities in Emergency Department (ED) visits diagnosed as schizophrenia/psychosis immediately following the police killing of George Floyd in May 2020. We used monthly data on ED visits from January 2016 to December 2020 across 5 University of California health systems. We used ARIMA (Autoregressive Integrated Moving Average) time-series analysis to derive the residual values of ED visits diagnosed as schizophrenia/psychosis among Black persons and examined whether these residuals increased selectively among Black persons in June 2020. Results from time-series analyses indicate 34 additional ED visits above expected levels diagnosed as schizophrenia/psychosis among Black persons in June 2020 (p < 0.05), amounting to a 25% increase in these visits among Black persons. These results indicate a perpetuation of historical trends and cohere with expectations from the legacy of “Protest Psychosis”.

Food insecurity is a major threat to global public health and sustainable development. As of 2022, 2.4 billion people worldwide experienced moderate to severe food insecurity. The occurrence and severity of food insecurity can depend greatly on power and social hierarchies, with women and girls often being less food secure than men and boys even within the same household. Moreover, social roles, such as the socialization of a mother to feed her children, impact food insecurity and its consequences. This study aims to uncover the relationships between food insecurity and mental health for women in the Chitwan Valley of Nepal. Utilizing longitudinal data from the Chitwan Valley Family Study, we connect food security data from 2015 with mental health data collected from 2016 to 2018. We find that women have a higher prevalence of major depressive disorder, generalized anxiety disorder, and panic attacks than men, especially if they are experiencing food insecurity. Among women, we find that those who have recently experienced severe food insecurity have a significantly higher likelihood of meeting diagnostic criteria for generalized anxiety disorder and panic attacks than food-secure women. However, women's food insecurity is not significantly correlated with major depressive disorder. Moreover, we find that food insecurity is likely to co-occur with women's agricultural and wage work. These findings suggest a need for gender-attentive policy and programs accounting for both causes and consequences of food insecurity.

Background

Postpartum depression (PPD) is a common experience among mothers worldwide. Family members, especially husbands, can play an integral role in supporting and helping mothers recover from PPD. However, husbands are typically not included in interventions to address postpartum depression among women. This study explored husbands’ perspectives on engaging in a counseling intervention augmented with a digital health component for the treatment of PPD.

Methods

A convergent mixed methods design was used to evaluate husbands’ attitudes and involvement in a counseling and digital intervention for mothers in a semi-urban region of Nepal.

Thematic analysis of semi-structured interviews was used to derive emergent themes. A joint display examined differences in themes for husbands whose wives experienced a significant decline in PPD symptoms as measured by the Patient Health Questionnaire-9 pre and post intervention, as compared to husbands of women whose symptoms stayed the same or worsened.

Results

Thirteen husbands were interviewed. Three primary themes emerged: the impact of gender norms and attitudes on engagement in the intervention, involvement and support in the intervention, and suggestions for future interventions for PPD. Among wives who experienced a reduction in depression symptoms, their husbands were more likely to endorse gender-equitable norms and attitudes and the husbands provided emotional support, as well as participating in household chores and childcare.

Conclusion

When husbands are living in the same household, providing support and being involved in their wives’ PPD treatment can help them recover. Husbands describe time at home and work as barriers to being able to help their wives. PPD interventions that involve husbands might need to educate husbands about how they can provide emotional support to their partner.

Residing in poverty-impacted Ugandan communities and raising children with disruptive behavior disorders (DBDs) is associated with above heightened parenting stress. An evidence-based intervention designed to help parents tailor their parenting style to effectively manage children with DBDs was implemented in Uganda between 2017 and 2023. At the end of the intervention, caregivers displayed lower levels of parenting stress than controls, however the mechanisms by which stress reduction occurred is unknown. We investigated whether the intervention's effect on parenting stress was mediated by parenting practices, family cohesion, or mental health.

Mediation was assessed using Mitchell and Maxwell's cross-lagged auto-regressive approach. Each mediation model regressed the outcome parenting stress score at each time point onto intervention group assignment (0 = Control; 1 = Multiple Family Group (MFG) intervention) and parenting stress score at the preceding time point. Each mediator was investigated one at a time and regressed onto intervention group assignment and the mediator score at the preceding time point. Parenting stress score was also regressed onto the preceding time point mediator score. The residuals for mediators and parenting stress were allowed to correlate at each time point. We included regression pathways from each covariate to the mediators and outcomes at subsequent waves and were included in the model as random variables.

The findings show that the intervention had a significant direct effect on parenting stress at 16 weeks post intervention initiation and was partially mediated by parenting practices, caregiver mental health, and parenting stress at 8 weeks, but we found no evidence it was mediated by family cohesion, supporting two of our hypotheses.

Equipping caregivers with parenting skills and strategies to improve mental health can go a long way in reducing overall parenting stress among caregivers with DBDs. Our findings could be leveraged to enhance stress reduction among caregivers of children with DBDs in the long-term.

This article presents the findings of a groundbreaking focus group cohort method of studying the residual impacts of traumatic stress and violence as reported by survivors and perpetrators of the Khmer Rouge genocide in Cambodia (1975–79). Both cohorts, separately participated in fifteen intensive focus groups lasting between one and five days across nine Cambodian provinces during 2012–13. This research focuses on the experiences of stress and violence by survivors and perpetrators during the genocide and since. The results of this study show that all 61 survivors and 58 perpetrators experienced multiple traumatic violent events during the genocide, and all lived in daily fear of being killed by the leaders of the Khmer Rouge. The results also show similar evidence of continued stress in both cohorts today, and parallel preoccupations with thoughts or memories of trauma and violence under the Khmer Rouge.

Background

In Vietnam, domestic violence (DV) is recognized as an intentional act of causing physical, mental, sexual, or economic harm among family members. Despite legislative efforts, DV remains prevalent, significantly impacting women's mental and physical health. Traditional beliefs and cultural norms further entrench DV, particularly among women and children, necessitating an understanding of perceptions and attitudes toward DV.

Methods

This exploratory cross-sectional study surveyed 81 Vietnamese university students to assess their perceptions, attitudes, and personal experiences of DV. Survey data was collected online and analyzed using descriptive statistics.

Results

The study found high awareness of DV, with most participants recognizing physical and psychological violence, while less awareness was noted for economic abuse. A majority perceived DV as fairly common (57%) and highly common (37%). Most participants attributed DV to alcoholism (93%), drug addiction (93%), and poverty or social exclusion (90%). Roughly half of the participants had friends or family victims who were victims (53%) or perpetrators (46%) of DV. Despite general knowledge of DV laws, many were unaware of specific legal and social support mechanisms. Notably, while most participants found DV unacceptable and should always be punishable by law (64%), actual reporting and intervention rates were low, with significant gaps in support awareness.

Conclusions

The findings highlight a substantial awareness of DV among Vietnamese university students but also reveal critical gaps in understanding and addressing economic abuse and available support systems. There is a need for enhanced education and accessibility of resources to effectively combat DV and support survivors, especially for young adults who would soon explore marriage and family lives.

Belief in a continuum of symptoms from mental health to mental illness (MI) has an impact on the social acceptance of people with MI. However, little is known about whether people's conception of MI itself and in particular how broad that conception is, has an impact on the social acceptance of individuals with MI or affects continuum beliefs. To address this research gap, it is necessary to capture and monitor public understanding of MI. Using 17 different statements that describe behaviors on a spectrum from mentally healthy to ambiguous to indicative of MI, we examine how the German public conceptualizes MI. Specifically, we develop a measure to capture the breadth of an individual's conception of MI. We find that a broader concept of MI is associated with greater social acceptability. In addition, we show that continuum beliefs and the breadth of the concept of MI interact – continuum beliefs are especially important for stigma reduction when individuals have a narrow concept of MI. For future research, this finding implies that with regard to social acceptance of people with MI, individuals with a narrow concept benefit from continuum interventions in particular.

This study investigates the co-creation process between course facilitators and students while the course takes place at recovery colleges (RCs), emphasising the synergistic partnership where individuals with lived experience of mental health issues collaborate with professionals in course delivery. This paper focuses on understanding the dynamics of these interactions from the students’ perspectives and the dynamic shifts between the private realm and the public space. We conducted a qualitative study inspired by critical ethnography, collecting data from participatory observations in RCs at two locations and focus group interviews with students. Goffman’s dramaturgical approach guided us in examining social interactions in RC as theatrical performances with students playing specific roles, managing impressions, and navigating the front and backstage of their lives. During the analysis, we separated the data into front- and backstage contexts where we identified moments where students were actively performing a social role and moments revealing more authentic sides of themselves. We demonstrate that a RC is a stage where students can test their performance and adapt to their audience’s reactions. Uncertainty about their roles, social scripts, and the audience’s reactions lead them to switch between front- and backstage appearances, either performing a role or revealing their authentic sides. While exploring appearances, students develop social scripts aligning with their roles as performers and audience, eventually promoting security by mutual understanding of appropriate appearances. Emotional support, collaborative relationships, and group dynamics were critical factors in fostering an environment conducive to authentic participation. Challenges persist, such as vulnerability, recognizing the value of personal contributions, and establishing personal boundaries. Safety within the college environment was paramount for genuine engagement in co-creation, leading to personal and collective benefits for mental health services. The study suggests an in-depth investigation into the structural and power dynamics that shape such interactive processes within RCs.

Background

Suicides, overdoses, and drug-related liver diseases (deaths of despair) are greatly elevated in the mining and extraction industries compared to other industries. To better understand the drivers of these deaths, we examined suicide or overdose mortality in relation to age at worker exit among a retrospective cohort of 11,009 male mine workers from the Diesel Exhaust in Miners Study II.

Methods

We calculated age-adjusted mortality rates (1947–2015) and estimated hazard ratios (HRs) and 95% Confidence Intervals (CI) for suicide or overdose death in relation to age at worker exit (leaving work). The mining industry curtailed its workforce in the early 1980s due to economic downturn; therefore, separate models were fit for worker exit pre- and post-1980.

Results

Suicide deaths peaked between 1980 and 1989 at 67.2 per 100,000, more than double the rate in the general population. The hazard rate for suicide or overdose was 2.56 times higher for inactive versus actively employed workers (95% CI: 1.88, 3.50). Based on 187 suicides or overdoses, associations between younger age at worker exit and suicide or overdose death were null or protective before 1980. However post-1980, those who exited between ages 30–39 years had an elevated risk of death HR = 1.33, 95% CI (0.70, 2.53) and those who exited before age 30 had a HR for suicide or overdose of 1.57 (0.83, 2.96) compared to those who exited work after age 55.

Conclusion

Worker exit may contribute to the elevated mortality from suicide or overdose among male mine workers, particularly among younger age groups.

Anecdotal evidence, commentary in the media, and research conducted by intergovernmental organizations in Vietnam indicate that sexism is commonly experienced by women in the Vietnamese workplace. However, few systematic studies to date have been conducted on the prevalence and types of sexism that Vietnamese women experience. This cross-sectional exploratory study seeks to inquire into women's experiences of sexism in the STEM field and its potential associations with mental health outcomes through the lens of ambivalent sexism theory, which categorizes sexism as benevolent and hostile. Vietnamese women employed in STEM (N = 148) completed online questionnaires assessing experiences of ambivalent sexism, perceived stress and perceived sexism, stress symptoms, depression, and anxiety. The results indicate that benevolent sexism is more common than hostile sexism and that younger women are more frequently targeted. Correlation and regression analyses indicate that benevolent and hostile sexism are positively correlated with women's mental health problems. The findings highlight that despite the gains made in workplace gender equality in Vietnam, sexism continues to pose a problem for women's career development in STEM as well as potential health and safety issues. The study concludes with measures that organizations can undertake to tackle the problem and recommendations for future research in Vietnam to build on this exploratory inquiry.