Mental health science最新文献

Although depression is common in primary care, challenges to timely intervention exist, particularly for communities of color and lower socioeconomic status. Our objective was to understand barriers and facilitators to mental healthcare access among a sample of patients receiving care at a federally qualified health center (FQHC) in Minnesota, United States. We qualitatively interviewed 34 patients of an urban FQHC, purposively sampled on race/ethnicity, insurance status, language, and depression symptom status (based on Patient Health Questionnaire-9 responses). We inductively and deductively analyzed interview data, leveraging theory in both the codebook development and analysis processes. Participants, who were predominantly English-speaking, female, not privately insured, and people of color, shared numerous barriers and facilitators to accessing mental healthcare. Prominent barriers primarily concerned healthcare providers, including perceived dismissal of mental health concerns and challenges with provider continuity. Additional barriers included the costs of mental health care, communication breakdowns, the patient portal, and community-specific perceptions of mental health. Prominent facilitators included clinic organizational factors (internal and external) and staff friendliness and warmth. Other factors including consideration of patients' financial situation, integrated management of behavioral and physical health conditions, language concordant staff, the telehealth visit modality, and the clinic's social mission were also raised as facilitating access. Patient voices from a single FQHC illustrate the challenges and possibilities of providing mental healthcare in safety net settings. Clinical, strategy, and policy solutions can be tailored to minimize barriers and optimize facilitators documented herein.

Much of our knowledge about the relationship between psychological variables related to sport and adolescent mental health is based on research from elite athletes. However, the vast majority of adolescents who engage in sports do so at the grassroots level. We therefore sought to understand how self-reported psychological variables and sleep may be associated with symptoms of depression and anxiety across one season in grassroots adolescent netball. We collected self-report, paper-based questionnaire data from adolescent netball players at one large netball club based in the West Midlands of the United Kingdom at the start of the season (timepoint 1, September 2018, N = 140) and end of the season (timepoint 2, March 2019, N = 132). Ages ranged from 11 to 19 (M = 13.54), which were categorized as under 14s (U14, ages 11–14) and under 19s (U19, ages 15–19). Participants self-reported symptoms of depression and anxiety, basic psychological needs related to netball, demands and resources related to netball, and sleep quality at each time point. We used standardized residual change scores to test whether changes in the psychological variables related to their engagement in grassroots netball (basic psychological needs, demands and resources) and sleep quality were associated with changes in depression and anxiety symptoms over time. We report that increases in perceived sporting demands and reductions in sleep quality were associated with elevated symptoms of depression over the season. Reductions in perceptions of autonomy were associated with increases in symptoms of anxiety. We report novel evidence that self-reported, malleable psychological variables related to sports participation, and sleep quality, are associated with mental health in youth female athletes competing at the grassroots level. It would be worthwhile to explore whether mental health interventions and/or education delivered via grassroots sports clubs may be an effective method for promoting mental health resilience in adolescent athletes.

Few studies have explored the views of fathers in relation to daughters diagnosed with anorexia nervosa (AN). The aim of this study was to investigate this aspect. This study was part of a larger study. Fourteen fathers (age 46–68 years) of 14 daughters (age 19–29 years) diagnosed with AN were interviewed between 1996 and 2002. The interview consisted of 15 open-ended questions exploring the views of fathers in relation to their daughters later diagnosed with AN. Following transcription, thematic analysis was used to identify main themes and subthemes based on the data. We identified three themes: “Family dynamic,” “Proximity and distance to the daughter,” and “Commitment and knowledge seeker,” and 10 subthemes. The fathers were involved during the upbringing and the relation to the daughter was important. Different studies show the importance of the paternal role for the daughter's healthy development, and for AN. Not sharing equally, the responsibility of early childcaring, could foster the experience of inadequacy regarding the paternal role in the future. In our study, the fathers considered the mothers to be the experts during the daughters' adolescence. This attitude could have hindered them from understanding their daughters pathological eating problems. This and other studies indicate the importance of viewing the fathers as a resource when planning treatment approaches.

This study investigated the effect of perceived physician burnout on psychological distress (anxiety, depression, and secondary traumatic stress) in physician spouses. Two-hundred and three physician spouses participated in the study between April and May 2021. Physician spouses completed a burnout measure on behalf of their physician partner, and psychological distress measures for themselves. Results showed perceived physician burnout was positively correlated with anxiety (r = 0.24), depression (r = 0.13), and secondary traumatic stress (r = 0.14) in physician spouses. A covariate analysis including eight demographic variables did not significantly contribute to the relationship between perceived physician burnout and psychological distress in physician spouses. Moderation analyses showed no significant interactions when the personality trait agreeableness, total score on a resiliency questionnaire, and compassion fatigue were included as moderators in the relationship between perceived physician burnout and psychological distress in physician spouses. These findings indicate that physician spouses experience secondary psychological distress when they believe their partner (the physician) is experiencing burnout, emphasizing the need for mental health support during medical training.

Racially minoritized women with limited socioeconomic resources are at increased risk for adverse psychological outcomes in response to the coronavirus disease 2019 (COVID-19) pandemic. Disproportionate rates of trauma exposure and economic insecurity likely heighten risk for these outcomes among socioeconomically vulnerable individuals, but the unique contributions of these factors are poorly understood. As such, we examined trauma and economic factors as predictors of pandemic-related psychological distress and symptoms. Ninety-six women recruited for a trauma research study (91.7% Black, M_age = 38.3 years, SD_age = 11.8 years) completed measures of trauma exposure, economic insecurity, and several items assessing psychological distress and symptoms related to the COVID-19 pandemic. We examined concern for mental and physical health impacts of COVID-19 as well as changes in self-reported levels of anxiety and anhedonia from the 3 months before the pandemic to the previous 2 weeks. Linear regression analyses were used to assess contributions of trauma exposure and economic insecurity to COVID-19-related distress. Childhood maltreatment and lifetime trauma exposure did not predict COVID-19-related distress; however, financial concern significantly contributed to concern for the physical health impact of COVID-19 (B = 0.30, p < 0.05). Food insecurity emerged as the only significant predictor of concern for the mental health impact of COVID-19 (B = 0.91, p < 0.01). Housing instability was the only significant predictor of COVID-19-related increases in anhedonia (B = −0.30, p < 0.05). Economic insecurity, namely, self-reported financial concern, food insecurity, and housing instability, was related to COVID-19-related psychological distress and symptoms in a sample of predominately Black American women living in under-resourced communities. Findings may help identify populations at risk for COVID-19-related psychological distress and symptoms and appropriate interventions, such as expanding access to nutritious food sources and housing support, for minoritized community members.

Individuals living in areas with high rates of poverty are disproportionately affected by posttraumatic stress disorder (PTSD). Despite this association, little is known about how neighborhood poverty rates impact risk for PTSD development. In the current prospective study, we determined the relationship between neighborhood poverty rate and PTSD symptoms 6-months after experiencing a traumatic event in a sample of varied race, gender, and socioeconomic status. Participants (N = 252) were enrolled in a hospital emergency department after experiencing a traumatic event. Demographic information (including zip code of residence), baseline PTSD symptoms, and baseline trauma history was assessed in the emergency department. PTSD symptoms were again assessed 6-months posttrauma. Neighborhood poverty rate was determined using the American Community Survey. Correlation analyses revealed that neighborhood poverty was significantly associated with baseline PTSD symptoms (r = 0.181, p = 0.004) and PTSD symptoms 6-months posttrauma (r = 0.163, p = 0.009). A regression analysis controlling for baseline trauma exposure, clinician-rated trauma severity, and individual socioeconomic status demonstrated that neighborhood poverty predicted PTSD symptoms six-months posttrauma (R² = 0.099, B = 0.15, p = 0.04), but this relationship was no longer significant when baseline PTSD symptoms was added as an additional covariate (R² = 0.304, B = 0.07, p > 0.05). Overall, results suggest that neighborhood poverty generally increases PTSD symptom severity, and the context in which an individual lives should be considered when conceptualizing risk for PTSD.

Persons with bulimia nervosa (BN) often experience psychosocial difficulties, in particular heightened sensitivity to social rejection and a negative bias toward their social environment. Conversely, social competence and close friendships are protective against mental ill health. The aims of this study were to evaluate the interpretation of ambiguous social scenarios in females with and without BN and to assess the relationship between interpretation biases and clinical characteristics. Females with BN (n = 35) and controls (n = 35) were recruited via social media. Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), Adult Rejection Sensitivity Questionnaire, the Depression Anxiety and Stress Scales (DASS), and finished sentence stems depicting ambiguous social scenarios. Completed sentence stems were rated as positive, neutral, or negative by blinded researchers. Females with BN made fewer positive and more negative interpretations of sentence stems than controls. The frequency of negative interpretations correlated positively with clinical symptoms on the EDE-Q, A-RSQ, and DASS. A negative interpretation bias was found in females with BN, which aligns with the finding shown by Cardi et al. that females with anorexia nervosa have a negative interpretation bias toward ambiguous social scenarios. This bias was not only associated with eating disorder psychopathology but also with depression, anxiety, and stress, highlighting a potential transdiagnostic role. Interventions that address psychosocial difficulties might prevent the onset, reduce symptoms, and improve prognosis.