SSM. Mental health最新文献

Understanding why people identify themselves as having a mental disorder is crucial for making sense of recent rises in self-diagnosis and help-seeking. Previous studies have implicated factors such as levels of distress, mental health literacy, and stigma. Motivated by concept creep research, we tested whether self-diagnosis is also associated with the expansiveness of people's concepts of mental disorder. A nationally representative sample of 474 Americans completed measures of distress, impairment, mental health literacy, stigma, and newly validated concept breadth scales, in addition to current and lifetime mental disorder (both self- and professionally-diagnosed) and help-seeking. Structural equation modeling demonstrated that participants with broader concepts of disorder were more likely to self-diagnose and seek help, independent of distress and impairment, mental health literacy, and low stigma. Holding broader concepts also partially accounted for higher levels of self-diagnosis among younger and more liberal participants and predicted self-diagnosis independently of formal diagnosis. Implications for the surge in self-diagnosis and concerns about pathologization of everyday life are discussed.

This qualitative exploratory research delves into the intricate life narratives of forcibly displaced individuals residing within the Emergency Transit Mechanism in Niger, employing a methodology grounded in life narrative analysis. The primary objective is to gain a comprehensive understanding of the potential stressors and traumatic experiences encountered by these individuals, encompassing both psychological and physiological dimensions, while also examining the dynamics of resilience and elements contributing to their overall well-being. The findings, derived through thematic content analysis, underscore the cumulative nature of traumatic events experienced by migrants throughout their lifetimes and across various stages of the migration continuum. The study, in alignment with extant scholarly literature, identifies thematic categories such as “A scenario of conflict and mourning, " everyday experience of violence and discrimination,” “health at risk”, and " Seeking security.” Refugees recount enduring multiple traumas, including familial bereavements and losses resulting from conflicts and militarized violence. Furthermore, the analysis elucidates a profound interplay between traumatic occurrences, subjective well-being, and resilience among the studied population. Despite confronting adverse living circumstances, refugees demonstrate indicators of subjective well-being, hinting at the potential for resilience and recovery. This challenges conventional diagnostic frameworks such as Post-Traumatic Stress Disorder (PTSD) and underscores the necessity for a nuanced understanding of trauma's multifaceted impacts. Nevertheless, the study underscores the urgent need for a more robust and contextually attuned mental health support infrastructure, advocating for a deeper exploration of the socio-political determinants underpinning forced migration. By comprehending the root causes of displacement through a socio-political lens, policymakers and practitioners can devise comprehensive strategies and interventions aimed at both prevention and mitigation of factors precipitating forced migration. This approach seeks to foster a global landscape wherein compassionate and well-informed interventions proactively address the underlying drivers of displacement.

Background

Ovarian cancer (OC) patients have an increased risk for a mental health illness (MHI) after their cancer diagnosis, but limited research exists on whether this risk differs by race/ethnicity. Hence, we used SEER-Medicare data to evaluate racial/ethnic differences in MHI incidence among OC patients aged 65+.

Methods

Non-Hispanic (NH) Black, NH White, and Hispanic women diagnosed with OC in 2008–2015 without a mental health history 12 months prior to their cancer diagnosis were identified from SEER-Medicare. Cox proportional hazards regression evaluated new MHI incidence in the first five years post diagnosis and the differences by race/ethnicity. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for demographic/clinical covariates and healthcare access (HCA) dimensions.

Results

We identified 5441 OC patients, including 364 NH Black (6.7%), 4982 NH White (91.6%), and 95 Hispanic (1.7%) patients. About 41% of NH White, 33.3% of NH Black, and 37.2% of Hispanic OC patients were diagnosed with MHI during the follow-up period between 2008 and 2016. In the fully adjusted model, NH Black OC patients were less likely to be diagnosed with any MHI (aHR: 0.67, 95% CI: 0.54, 0.82), depression (aHR: 0.66, 95% CI: 0.51, 0.85), and anxiety disorder (aHR: 0.64, 95% CI: 0.49, 0.84), while Hispanic OC patients were less likely to be diagnosed with anxiety disorder (aHR: 0.56, 95% CI: 0.33, 0.95) compared to NH White OC patients.

Discussion

NH Black OC patients are less likely to receive a clinical MHI diagnosis compared to NH White OC patients. Further studies on racial differences in MHI incidence after OC diagnosis in primary cohorts are needed to better estimate population-level prevalence less vulnerable to exposure misclassification and to account for patient-level factors impacting MHI.

Objective

The goal of this scoping review was to assess the scope and nature of evidence concerning culturally sensitive grief treatment and support interventions, aiming to provide valuable insights for future research on grief intervention development.

Introduction

Prolonged grief disorder (PGD), associated with adverse psychosocial outcomes, requires treatment. The norms of a person's culture influence grief expression, mourning rituals, and perspectives on death. Despite increasing interest in culturally sensitive grief interventions, a comprehensive synthesis of evidence is lacking. A scoping review was deemed fitting to address this gap.

Inclusion criteria

This review included studies featuring participants experiencing clinically relevant grief and engaged in culturally sensitive psychosocial grief interventions. It included studies conducted in non-WEIRD contexts or those focusing on sociocultural (sub)groups distinct from the majority (in terms of age, religion, sexual orientation, etc).

Methods

Following JBI methodology for scoping reviews, 13 databases were searched (Scopus, Embase, Cochrane, Sociological Abstracts, IBSS, PTSDpubs, PsycINFO, PsycArticles, PSYNDEX, MEDLINE, CINAHL, SocINDEX, and Web of Science). Limits included language (English and German), peer-reviewed articles and publication date (from 2000). The two-step screening process (titles and abstracts, full text) was piloted, and data were extracted and collated.

Results

Eighteen studies were included, displaying diversity in geographical location, methodology, and target populations. Interventions targeted various forms of clinically relevant grief, lost relationships, and sociocultural groups. Cultural adaptation processes varied, with seven studies using a top-down approach. Sources of information for formative research involved theoretical models and empirical data, while local experts and qualitative research (e.g., key informant interviews) informed cultural adaptation. Outcome measures were diverse, with 15 studies showing significant pre-post intervention changes, while two did not.

Conclusions

The review highlighted the emerging significance of culturally sensitive interventions for PGD, emphasizing the need for standardized approaches and further research. By shedding light on gaps and providing recommendations, it offers insights for future researchers in this field.

Rising mortality due to suicides, overdoses, and substance-related diseases, also called “deaths of despair,” has attracted significant academic, public, and media attention in recent years. This type of mortality, and key precursor “diseases of despair” like depressive mood and substance-related problems, tend to concentrate in people affected by deindustrialization and the loss of well-paid industrial jobs, that is, working-age adults with less than a BA degree. It is thought that risks build up when young adults with less education struggle to find decent jobs upon entering the labor market, which in turn triggers (1) subjective perceptions of being stuck in lower socioeconomic rungs; and (2) exposure to chronic stressors in various domains (e.g., housing, relationships). This study examined whether wages were related to diseases of despair (i.e., depressive mood and substance-related problems) through these two types of processes in a longitudinal sample (N = 543) overrepresenting young Canadian adults with lower educational attainment followed from their mid-teens to their mid-20s. Psychological processes and outcomes were self-reported, whereas exposure to stressors was assessed with a gold-standard interview-based protocol. After taking into account key potential confounders measured in adolescence (e.g., stressor exposure, mental health symptoms), results show that wages in early adulthood (in the early and mid-20s) were indirectly associated with depressed mood and substance-related problems in the mid-20s, through internal psychological processes and external exposure to chronic stressors. The specific processes in play varied by outcome. For depressive mood, subjective perceptions of one's relative socioeconomic position emerged as particularly relevant, whereas for substance-related problems, significant indirect associations emerged only when both internal psychological processes and external exposures to stressors were considered jointly. Access to decent jobs offering good wages among young adults without university degrees should thus be considered when designing policies aimed at reducing diseases of despair in younger generations.

Background

The Arab Region accounts for most of the world's refugees. Despite being dispersed across the globe, most of these refugees are internally displaced within the region. A growing body of research argues that Western biomedical frameworks for conceptualizing, diagnosing, and treating trauma may not be suitable for non-Western and trauma caused by political violence inflicted on entire populations over time. The cultural and socio/political contexts of trauma are increasingly recognized as key to understanding trauma-related distress. Arab trauma research has emerged in the past 30 years. Nevertheless, the results are not systematically consolidated.

Aim

This review aims to identify and map knowledge production in the Arab Region that is challenging Western notions of trauma experienced by Arab refugees in the region and attempts to explore the contours of a more culturally congruent conceptualization of trauma.

Method

Following the PRISMA extension for scoping reviews (PRISMA-ScR), we conducted a scoping review. Peer-reviewed, empirical literature from 1990 to 2023 was searched in eight English and three Arabic databases.

Results and implications

Out of 2654 articles only ten were included. Included publications explored two main areas: conceptualization of trauma in Arab samples and addressing the subject of traumatization. The articles highlighted the limitations of using the PTSD model to diagnose and treat Arab refugees' traumatic stress and the importance of contextual, structural, and cultural factors in distress conceptualization. The articles provide research, clinical, and policy implications addressing adoption of social justice frameworks, development of contextually relevant trauma models, clinical investigations and assessment of symptoms and idioms.

The initial year after parental death is a critical period for grief and coping. Despite its significance for declines in and recovery of adult mental health, this initial period is not sufficiently captured in existing research following changes across annual or even broader intervals. This paper assesses the impact of the first and second parent’s death on adult mental health on more fine-grained monthly timescales. Using data from up to 12 waves of the German Socio-Economic Panel Study (GSOEP) and fixed-effects models with yearly and monthly impact functions, the analysis yielded two main findings. First, mental health declines were much deeper when measured on a monthly scale. The magnitude of drops recorded within the first two months following parental death approximately doubled those measured at an annual scale. Second, recovery occurred much faster when recorded on a monthly timescale and was evident already a few months after the loss of a parent. Overall, this study suggests that reaction and adaptation to parental death are stronger and faster than previously documented. The study additionally identified variations in mental health responses. Those who lost their first parent had worse mental health a year after the event compared to those who lost their second parent. The most significant decline in mental health, around 10 points, occurred among daughters one to two months after their mother's death. When the mother died first, the impact was more severe on mental health, especially among younger daughters and sons.

Implementation science and human-centered design (HCD) offer useful frameworks and methods for considering and designing for individuals' needs and preferences when implementing new interventions or technologies in global health. When used in tandem, the two approaches may blend creative and partnered research methods with a focus on the factors necessary to design, implement, and sustain interventions. However, research is needed that describes the process of blending these two approaches and explores the experiences of community partners. This study builds from a stepped-wedge cluster-randomized trial in Western Kenya, wherein teachers and community health volunteers have been trained to provide trauma-focused cognitive behavioral therapy (TF-CBT). Mobile phones emerged as a tool to supervise lay counselors from afar; however, their use was characterized by unique challenges. Informed by human-centered design and implementation science, we first engaged lay counselors (n = 24) and supervisors (n = 3) in individual semi-structured interviews then hosted an in-person participatory workshop to “co-design” solutions to optimize the use of mobile phone supervision. Lay counselors participated in focus group discussions regarding their experiences in the workshop. Focus group transcripts were analyzed using thematic analysis. We describe our approach as well as focus group discussion results. Counselors felt the workshop was a valuable experience to learn new strategies from their colleagues, and they enjoyed the “collaborative spirit” that emerged as they worked together. Counselors felt that varying small and large group discussions fostered participation by creating opportunities for more people to engage and share their thoughts. Counselors suggested the approach be improved by providing more tangible materials (e.g., hand-outs) and more closely following a schedule of activities. It is important to also center stakeholders’ experiences as partners in the research process. Though counselors largely expressed positive sentiments, they also shared valuable suggestions for how to improve participatory research practices in the future.