SSM. Mental health最新文献

Loneliness results from unfulfilled social relationship expectations (SREs). Little research has investigated how SREs vary by culture and context, how loneliness is experienced in rural Southeast Asia, and how loneliness relates to care provision in later life. The current study qualitatively explored the understanding of loneliness, contextual differences in the content, avenues, and obstacles for SREs, and care provided by Myanmar and Thai people living at the border in Chiang Rai. Data were analysed using thematic analysis. Between November and December 2022, 10 focus group discussions were held with 17 migrants from Myanmar and 33 older people from Thailand. Emerging themes from the focus groups shed light on how loneliness differs between cultures and contexts. Loneliness was experienced particularly at night, when people thought about their unmet relationship expectations. Having “nothing to do” and overthinking were closely related to the experience of loneliness, whereas engaging in activities, including caregiving, alleviated loneliness. Compared to Myanmar adults, Thai older adults were more likely to have family members nearby but less likely to share personal problems and feelings of loneliness with others. Fulfilling the SREs of proximity, generativity, and respect was more challenging for Myanmar migrants, who had been unable to return home for years while struggling with financial insecurity.

This study assessed perception and experience of trained primary health care workers in using a mobile app-based version of the WHO mental health gap action programme (mhGAP) Intervention Guide in the assessment and management of people with mental health conditions in primary care in Nepal. A qualitative study was conducted with primary healthcare workers who were trained in using the WHO mhGAP mobile application in Jhapa, a district in eastern Nepal. Semi-structured interviews were carried out with 15 healthcare workers (3 females and 12 males) nine months after the training. Interviews were audio recorded, transcribed and translated into English for the thematic qualitative data analysis. Health care workers (HCWs) found the mobile app helpful to verify and confirm their assessment and diagnosis. The other benefits reported by the participants were: bringing uniformity in diagnosis and management of mental health conditions across primary healthcare facilities; reminding the HCWs specific assessment questions; creating awareness on the importance of psychosocial intervention; improving the interaction between patients and service providers; and the importance of follow-up care. Despite these advantages, lack of clarity about report submission modality; lack of electricity or internet connectivity; and low technology literacy among older HCWs were some of the barriers in using the app. The major recommendation made by the HCWs for the guide included revision of the assessment process and system; inclusion of a chat function with supervisors; minimizing the amount of patients’ data to be collected in the app; and addition of conversion and anxiety disorders to the app. This study concludes that the mobile decision support application could be acceptable and feasible in primary care settings if the suggested modifications are incorporated, in addition to addressing other systemic issues facing the primary care-based delivery of mental health services.

Despite evidence indicating that depression is prevalent in men, gender stereotypes persist that position the disorder as feminine. This misperception may contribute to men's underdiagnosis with and undertreatment for depression. We applied the shifting standards model (SSM) to advance predictions about gender differences in the evaluation of individuals described as experiencing depression. These predictions took the form of objective and subjective evaluations, as well as minimum and confirmatory standards. We randomly assigned participants (N = 430) in a 3 (target gender: man, woman, control) x 2 (judgment standards: minimum, confirmatory) between-subjects experiment. Participants read a vignette describing a woman, man, or individual of unspecified gender and provided the evidence they would need to suspect or confirm depression in the target individual consistent with minimum and confirmatory judgment standards. Results from the pilot and main studies indicate more gender similarities than differences. We discuss the findings with respect to the SSM and how the increase in mental health salience during the COVID-19 pandemic may have mitigated gender stereotypical views of depression.

Only a small proportion of refugees requiring treatment actually receive psychotherapy. Alongside structural barriers, it has been hypothesized that causal attributions for mental health problems that deviate from Western explanatory models may reduce refugees' help-seeking behavior. Prevailing assumptions suggest that refugees predominantly hold causal beliefs that are incompatible with the rationales of psychotherapy. Testing these assumptions requires a reliable assessment tool to evaluate refugees' causal beliefs. Therefore, we developed the Causal Attributions for Mental Health Problems Scale (MH-CAUSE) and validated it in a sample of Middle Eastern refugees living in Germany (N = 429). The outcomes of the psychometric analysis, which included exploratory and confirmatory factor analysis, internal consistency, and convergent validity, indicate that the MH-CAUSE is a suitable instrument for assessing refugees' causal beliefs about mental health problems. Our findings suggest that refugees' causal attributions are in line with a biopsychosocial-spiritual model of mental illness. Contrary to common assumptions, the majority of participants predominantly explained mental illness via psychosocial and biomedical causes, whereas spiritual beliefs were relevant only for a minority of participants. We observed significant associations between causal beliefs and help-seeking attitudes and behavior. However, effect sizes were only small to moderate. While mental health beliefs might contribute to mental health inequities, alleged cultural differences of refugees should not be overemphasized.

The current study investigated characteristics of resilience and posttraumatic growth in a sample of Rwandan genocide survivors. One hundred and sixty-three participants provided responses to a series of open-ended questions about resilient functioning among members of their community, as well as their own experiences of posttraumatic growth since the genocide. An overall theme in the responses was the role of environmental characteristics in both resilience and posttraumatic growth, which was apparent through the high frequency of codes such as family, means, work, and education. Furthermore, there was considerable overlap in identified domains of resilient functioning and posttraumatic growth. The results suggest that in this particular context, resilience is predominantly characterized by environmental features rather than individual characteristics. This has implications for interventions in Rwanda as well as the validity of current models and measures of resilience and posttraumatic growth in different cultures.