SSM. Mental health最新文献

Water insecurity and other social-ecological factors may be associated with depression in low and middle-income contexts (LMICs). This is understudied among urban refugee youth in LMICs, who experience multiple forms of marginalization. We conducted a cross-sectional survey with a peer-driven sample of urban refugee youth aged 16–24 in Kampala, Uganda. We explored: the prevalence of depression (moderate, moderately severe); associations between social-ecological (structural, community, interpersonal, intrapersonal) factors and depression; and associations between an Index of Vulnerability (IoV) comprised of social-ecological stressors and depression. Among n = 335 participants (mean age: 20.8 years, standard deviation: 3.1), in multivariable analyses, longer time in Uganda, water insecurity, lower social support, parenthood, and recent intimate partner violence were associated with moderate depression; and longer time in Uganda, water insecurity, and lower social support were associated with moderately severe depression. IoV scores were associated with moderate depression among men and women, and moderately severe depression among women. The IoV scores accounted for more variance in moderate/moderately severe depression among women than any single indicator; among men, water insecurity was most strongly associated with moderate depression. Future research can explore strategies to address water insecurity and other social-ecological stressors to promote health and wellbeing with urban refugee youth.

Bipolar disorder has risen in prominence in recent years, arguably in part through its association with various celebrities and positive related attributes such as creativity. The category itself has also widened with increasing numbers seeking out the diagnosis. Drawing upon observations of a psychoeducation programme for bipolar disorder and semi-structured interviews with those diagnosed, this paper considers the role of diagnostic prestige and essentialism in shaping identificatory practices surrounding bipolar disorder. The data suggests that bipolar comes to fulfil a meaningful explanatory role for participants, providing an important sense of group belonging and identity.This tendency to positively relate to bipolar in order to promote social cohesion and positive self-understandings is linked to the practice of ‘strategic essentialism’ (Spivak, 1990; Voronka, 2017), whereby category homogeneity is emphasised. The benefits associated with the diagnosis arguably encourage boundary making and homogenisation in order to prevent category dilution and loss of meaning. As such, while essentialism can be helpful in maintaining group cohesion, it is also associated with diagnostic possessiveness, whereby individuals undermine the diagnostic claims of others, creating divisions between those with and without the diagnosis.

Background

Gun violence is a global public health concern that has significant implications for mental health. This systematic review aims to synthesize the existing literature on the mental health consequences of interpersonal gun violence.

Methods

A comprehensive search was conducted across PubMed, PsycInfo, and Web of Science databases to identify relevant studies published up to December 15, 2023. Studies were included if they documented the mental health impact of interpersonal gun violence. The data extraction process included information on study design, population characteristics, exposure to gun violence, mental health indicators, and measurement instruments.

Results

A total of 58 studies were included in the review. The studies varied in design, population, and mental health indicators assessed. We found that exposure to interpersonal gun violence was significantly associated with increased reports of post-traumatic stress disorder, depressive symptoms, and substance use. We also found that interpersonal gun violence exposure was associated with increased disruptive behaviors and the likelihood of gun carrying especially among adolescents. Further, those closer to the interpersonal gun violence consistently reported more adverse mental health consequences than persons less centrally involved. The review also highlighted limitations in the current literature, including a narrow focus on certain mental health indicators and a paucity of studies from countries other than the US.

Conclusion

The consequences of interpersonal gun violence extend beyond immediate physical injury to include enduring mental health impacts. This review also highlights the need for further research to better understand the impact of gun violence on mental health.

Epidemiological studies conducted in high-income countries have shown that immigrant mothers and their children suffer from an augmented morbidity and mortality, including with regard to their mental health. Drawing on the “niche sociality” concept (Manning et al., 2023) as an analytic tool, our paper aims to analyze the postpartum experience of immigrant mothers in Switzerland as well as the circumstances to which these mothers connect their experience and often their distress. This qualitative study included semidirected interviews with immigrant mothers (n=20) and with the health and social care professionals who cared for them (n=26) as well as ethnographic observations. We conducted a thematic analysis and triangulated the data produced with mothers themselves and professionals. Immigrant mothers shared mixed feelings regarding their experience. They often lived their maternity while experiencing a gendered loneliness. As members of transnational families, they dearly missed their relatives living abroad. Their position as new mothers and as immigrant persons comprised complex sociomaterial ordeals related to their (un)employment, housing, and sociality. Drawing from their practice in the community, professionals' narratives completed mothers'. Professionals critiqued the unequal access to quality health care as well as the petty measures that interfered with mothers' and infants’ safety that were taken by street-level bureaucrats (Lipsky, 2010 (1980)). Reflexive and engaging, mothers shared sensible and nuanced narratives about their experience and initiatives to rebuild their niche sociality.

Benefits of parental gender-affirming behaviors on the mental health and well-being of the broader gender-expansive youth population have been extensively documented. However, the nature and impact of these behaviors have not been explored by centering Black and Latine transgender/non-binary youth (BLTY). This article offers a new framework called the “Parental Gender Affirmation Model.” This framework conceptualizes parental gender-affirming behaviors toward BLTY through the lenses of intersectional stigma and cultural gender norms and uses the Theory of Planned Behavior and Modified Gender Affirmation Model as foundational frameworks. We analyzed qualitative data from 43 interviews with BLTY, parents of BLTY, and Black and Latine transgender/non-binary young adults from California in the United States to develop the framework. The “Parental Gender Affirmation Model” starts with behavioral antecedents and ends with impacts of these behaviors on BLTY's well-being. This framework will inform the development of critically needed, culturally-informed interventions to support parental gender affirmation of BLTY.

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all.

Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional model with correlated errors was tested for equivalence across study countries using confirmatory factor analyses and the alignment optimization method. Results displayed 30 % noninvariance (i.e., variation) for both intercepts and factor loadings across all countries. Monte Carlo simulations showed a correlation of 0.998, a good replication of population values, indicating minimal noninvariance, or variation. Items “so nervous,” “lack of energy/effortful tasks,” and “tired” were consistently equivalent for intercepts and factor loadings, respectively. However, items “depressed” and “so depressed” consistently differed across study countries (R² = 0) for intercepts and factor loadings for both items.

The K10 scale likely functions equivalently across the four countries for most items, except “depressed” and “so depressed.” Differences in K10 items were more common in Kenya and Ethiopia, suggesting cultural context may influence the interpretation of some items and the potential need for cultural adaptations in these countries.

Sexually minoritized women (SMW) may be at an increased risk of adverse perinatal mental health, though prior research is limited. We examined sexual orientation-related differences in perinatal mental health (i.e., stress and depression), and antidepressant utilization among those at different severities of clinically significant perinatal depressive symptoms.

Nurses’ Health Study 3 participants with prospectively assessed pregnancies (N = 6,364) received pregnancy and postpartum questionnaires. Using weighted log-binomial generalized estimating equations, we examined differences in stress (Perceived Stress Scale 4 [PSS-4]), depression (the Edinburgh Postnatal Depression Scale [EDPS] at four cut-off scores [≥7, ≥9, ≥11, ≥13]), and patterns of antidepressant utilization across five groups: completely heterosexual with no same-sex sexual partners (reference group; n = 5,178); heterosexual with same-sex sexual partners (n = 245); mostly heterosexual (n = 770); bisexual (n = 106); and lesbian (n = 47).

Compared to the completely heterosexual reference group, SMW reported increased stress during pregnancy (adjusted risk ratio [ARR]: 1.14, 95% confidence interval [1.02–1.28]). SMW reported an elevated risk of pregnancy depression at every EDPS score cutoff, with the magnitude of the disparity increasing as the score increased (ARRs: 1.09 [1.00–1.20]; 1.20 [1.05–1.36]; 1.37 [1.16–1.63]; 1.49 [1.18–1.89] for EDPS scores ≥7, ≥9, ≥11, ≥13, respectively). Disparities were highest in magnitude among the mostly heterosexual and bisexual subgroups. Utilization of postpartum antidepressants increased among the reference group with increasing symptom severity but was only associated at the highest score (≥13) among SMW subgroups.

SMW have increased risks of pregnancy stress and depression and are more likely to use perinatal antidepressants; mostly heterosexual and bisexual individuals had the highest risk of antidepressant use. Postpartum symptom severity closely corresponded to antidepressant use among completely heterosexual, but not SMW—suggesting disparities in mental health treatment. Further research priorities include determining the causes of these disparities and appropriately tailored solutions.

Complex post-traumatic stress disorder (CPTSD) was introduced in the ICD-11 as a new diagnosis and was framed in accordance with WHO guidelines of clinical utility and cross-cultural applicability. CPTSD diagnosis comprises PTSD symptoms in addition to specific symptoms related to the organization of the self (DSO). Cross-cultural validity of the DSO symptoms is still being debated as cultural norms significantly influence how individuals perceive themselves and manage their emotions and relationships. The aim of this systematic review was to understand how PTSD and DSO symptoms were experienced and expressed by individuals from Sub-Saharan Africa (SSA) by exploring qualitative literature. Searches were conducted on nine databases using search terms for countries, methods, symptoms, and trauma exposure. Fifty studies were included. Results confirmed the presence of the three DSO clusters. However, their manifestation differed significantly from the defined diagnostic criteria, highlighting the importance of considering cultural factors in the diagnostic process. Additionally, the review indicated that structural factors played significant roles in shaping the interpretation of trauma-related distress in this cultural context. Thus, we propose to create and implement a cultural module as an add on to the actual CPTSD assessment tools to account for cultural and structural variations in the SSA population and improve diagnosis accuracy. In this perspective, more emic research is needed to gain a deeper understanding of how trauma-related distress is perceived, experienced, and interpreted in SSA.