Mental health science最新文献

Although rates of suicide among Black American youth have increased in recent years, few brief assessment tools have been culturally tailored and validated to better identify suicide risk for this population. The current study addresses this gap by testing the validity and reliability of the Cultural Assessment of Suicide Risk-short form (CARS-S) in an online sample of Black American adolescents. Three hundred eighty-one Black adolescents (M_age = 17.5) completed a 13-item CARS-S measure online. Cronbach's alpha and exploratory and confirmatory factor analysis were computed in Stata v.15 and Mplus v.8.0. The revised CARS-S scale demonstrated acceptable internal consistency (Cronbach's α = 0.82). A four-factor solution retained through exploratory analysis demonstrated the best model fit (χ² = 46.62, p < 0.001; RMSEA = 0.05, 95% CI = 0.01–0.08 CFI = 0.99; TLI = 0.97) compared to other model solutions. Confirmatory analysis supported a four-factor model with no cross-loaded items. The four factors were: (1) Family conflict and idioms of distress-suicidal actions (four items); Social Support (two items); Minority-specific distress (three items); Idioms of distress-emotional/somatic and cultural sanctions (four items). Researchers conducting future suicide prevention research focused on Black American adolescents and including the CAR-S measure should consider the inclusion of items related to family conflict and racism-related stress to better capture risk.

Social isolation due to the COVID-19 pandemic was a significantly destabilizing factor for people with borderline personality disorder (BPD). The aim of this study was to investigate the well-being of Australians diagnosed with BPD during the initial lockdown to restrict the spread of COVID-19. An online survey asked Australian residents (≥ 18 years) who self-identified with having a diagnosis of BPD, about their experience of “coronaphobia” using the Coronavirus Anxiety Scale (CAS) as well as using open- and close-ended questions to measure demographic and health information. The CAS data were analyzed descriptively. The World Health Organisation definition of health was used for deductive thematic analysis of qualitative data. Thirty-five (24.5%) of the 143 participants who completed the CAS, experienced dysfunctional COVID-19 related anxiety. Nearly half (n = 76; 46.1%) reported that their mental health became a lot worse. Utilizing the WHO definition of health, two main themes were identified: (1) Physical Health, and (2) Mental and Social Well-being. Both themes included three subthemes that were variously affected by the national lockdown. Following the imposition of social restrictions to control the spread of the coronavirus, many people living with BPD experienced heightened challenges and greater vulnerability to adverse outcomes attributable to their underlying mental health symptoms.

The present study evaluated the inter-rater reliability of the Heads Up Checkup (HCU), a brief digital mental health and behavioral adaptive screening system designed for use in primary care and diverse school settings. Two independent licensed clinical psychologists reviewed a random sample of 30 (N = 30) HCU clinical screening reports of 13−14 year old adolescents drawn from a larger sample (N = 846) enrolled in a public middle school in California. Results showed strong inter-rater agreement (Fleiss kappa = 0.93) between clinician ratings and the screener's priority risk index (HPI) in identifying students “in crisis.” In addition, clinicians' ratings of confidence in their priority judgments were found to be significantly higher for the “in crisis” cases. Reasonable evidence of convergent validity emerged due to a strong relationship between clinician ratings of psychological distress and the HPI. Overall findings suggest that as an online universal school-based screener, the HCU has valid utility for identifying young adolescents “in crisis” which can translate into timely interventions and pragmatic real-world therapeutic solutions. Future research directions with respect to the refinement of the HCU's measurement characteristics and its feasibility as an online screener at the population-level in schools are discussed.

Half of stroke patients experience depression, anxiety, and/or apathy, adversely impacting poststroke recovery. Yet management of these remains suboptimal. To identify the broad spectrum of therapeutic modalities investigated for post-stroke mood disorders, and their characteristics, administration regimens, and clinical outcomes. A structured, PRISMA-guided literature review identified studies exploring preventative or treatment options. Seventy-one identified studies (N = 5748 patients) comprised 62 clinical trials, 4 case reports, and 4 protocols or published abstracts. Most focused on depression; relatively few addressed anxiety and/or apathy. Overall, the efficacy of most treatments remains unclear due to the diversity and small size of studies (mostly pilot studies) precluding comparison. Preventative modalities such as nortriptyline (6 studies) reduced the incidence of depression, noting high rates of effectiveness in smaller studies (92.3%, study N = 48) patients. For the treatment of diagnosed mood disorders (58 studies), conventional pharmacotherapies (e.g., fluoxetine) were most effective, reducing depression, anxiety and/or apathy in up to 95.8% of patients (study N = 60). Physiological interventions (e.g., repetitive Transcranial Magnetic Stimulation, rTMS) variably reduced depression/anxiety severity (in 20.8%–93.3% of patients) whilst complementary therapies (e.g., acupuncture) reduced depression/anxiety severity in 60.0%–92.4% of patients (study N = 60). Combination therapies (e.g., fluoxetine plus acupuncture or rTMS plus Deanixt) significantly reduced depression severity in 93.3% of patients (study N = 60). Within the limited evidence in poststroke mood disorders, conventional pharmacotherapies appear most effective for both prevention and treatment, whilst nonpharmacological strategies and CAMs show potential. No treatment can be fully recommended without more robust trials.

Latinx adolescents, members of the largest historically minoritized population in the United States (US), experience pervasive ethnic-racial discrimination, adding extra challenges to this pivotal developmental stage which is marked by significant physical, cognitive, and psychosocial changes. Exposure to ethnic-racial discrimination is closely connected to their mental health. Physical activity has numerous psychophysiological health benefits, making it a potential yet understudied protective mechanism against the adverse impacts of perceived discrimination. By utilizing data from the Adolescent Brain Cognitive Development (ABCD) Study, the current study examined the buffering effect of physical activity in the association between perceived ethnic-racial discrimination and mental health in a national sample of Latinx adolescents (N = 1392; M_age = 11.92 SD = 0.66). Findings revealed that longer periods of moderate-to-vigorous physical activity exhibited a weaker positive association between perceived ethnic-racial discrimination and internalizing problems compared to peers who engaged in shorter periods of moderate-to-vigorous physical activity, indicating a protective role of physical activity for Latinx adolescents experiencing ethnic-racial discrimination. This study highlights the importance of promoting moderate-to-vigorous physical activity to support resilience and mental health in Latinx youth facing ethnic-racial discrimination.

Suicide is currently the 5th leading cause of death among children aged 5–11, a rate that has more than tripled in the last decade, and one that has increased significantly more among Black compared to White children. Specifying early childhood phenotypes of suicidality is critical for prevention of suicidal behavior. Such phenotypes need to be culturally relevant and rigorously tested in Black youth to yield data that will inform prevention science. We used the Interpersonal Theory of Suicide, to guide both the development of a theoretical model and a research protocol to conduct a study on suicidality in young Black children. The model was informed by an ecological adaptation which considers the context of structural, systemic, and interpersonal racism as critical for conceptualizing suicidal risk and identifying factors that reduce the likelihood of suicidal ideation and behaviors among Black youth. Developmental adaptations of IPTS components were based on existing research supporting associations between theoretically similar constructs and early childhood depression and/or later suicidality. Model components include loneliness and lack of family connectedness, low self-worth and hopelessness, and impulsivity. The components are measured via questionnaires and reactivity to behavioral probes as measured by facial emotion, heart rate variability, and self-reported mood. Risk and protective factors include exposure to racism and discrimination and racial identity and socialization, respectively. An accelerated, longitudinal design, enrolling 5–9-year-old children for 6 repeated assessments over 45 months will allow us to test stability from early childhood to early adolescence. Conducting robust tests of early risk and stability of suicidality in the context of culturally relevant risk factors (e.g., racism) and protective factors (e.g., racial socialization and identity) will contribute to efforts to reverse recent trends in Black youth suicide.

Mental health is at the forefront of discussions in healthcare, education, and social settings, yet eating disorders remain poorly understood and inadequately treated. This paper presents evidence on risk factors for insufficient recognition and intervention for eating disorders across clinical and community healthcare settings and proposes actionable strategies to improve awareness and early intervention for eating disorders. Specifically, gaps in eating disorder awareness and treatment access are exacerbated at two key intersections within health and social systems. First, eating disorders manifest themselves at the intersection of mental and physical categories of health, which places them at risk of being misunderstood, poorly diagnosed, and insufficiently intervened upon. Second, the peak onset of eating disorders falls at the intersection of adolescence and young adulthood, which is a period of rapid developmental, social change, and transitions in care. This analysis highlights how systemic issues within existing social and health systems underlie these intersections and contribute to the continued stigmatization and inadequate treatment access for eating disorders. Given their increased incidence and severity, there is an urgent need to address both the individual and societal burden of these disorders. Healthcare systems must prioritize coordination between physical and mental health practices and improve transitions in care from pediatric and adult healthcare services. Identifying gaps at intersections provides the opportunity to make concrete progress toward improving awareness and treatment.

Eye movement desensitization and reprocessing (EMDR) has demonstrated promise as a treatment for eating disorders (ED). The present study aimed to systematically evaluate the current evidence regarding the use of EMDR therapy in the treatment of EDs, ED symptomatology and body image concerns. Included articles were original studies that described the use of EMDR therapy in the treatment of EDs, published in the English language in a peer-review journal. The search was conducted using four electronic databases: PsycINFO, MedLine, Embase, and Web of Science. Two independent reviewers conducted screening, selection, risk of bias assessment and data extraction. Of the initial search of 109 potential studies, eight met inclusion criteria, including six case studies, one quasi-experimental study, and one randomised control trial (RCT). The RCT indicated that including an EMDR component did not have benefits over standard treatment for core ED symptoms, whereas the quasi-experimental study demonstrated some benefits for inclusion of EMDR as a treatment adjunct for anorexia nervosa patients. Case studies indicated some promising outcomes for patients with various presentations. Despite EMDR being an available treatment for several decades now, there is limited clinical evidence regarding its efficacy in the treatment of EDs. These findings highlight a critical need for more clinical research in this area to ensure clinical practice is guided and supported by evidence-based outcomes.